요척주관 협착증 환자의 요부 교감신경 차단술의 효과 및 조영양상에 따른 피부 체온의 변화

Abstract

Background: We hypothesized that if a fluoroscopic image of the lumbar sympathetic ganglion block (LSGB) showed the spread patterns of contrast at both the L2/3 and L4/5 disc areas, then this wouId demonstrate a more profound blockade effect because the spread patterns are close to sympathetic ganglia. In addition, we compared the effects of LSGB and transforaminal epidural steroid injection (TFESI) for the patients suffering with spinal stenosis.

Methods: Eighty patients were divided into two groups (Group S: the patients treated with TFESI, Group L: the patients treated with LSGB). The patients of group L were classified into three groups (groups A, B and, C) according to their contrast spread pattern. The preblock and postblock temperature difference between the ipsilateral and contralateral great toe (DT^6, DT9051, °C), and the DTnet were calculated as follows. DTnet = DTpost - DTpre.

Results: Both group showed a significant reduction of the visual analogue score (VAS) and the Oswestry disability index (ODI) score. Only the patients of group L showed a significant increase of their walking distance (WD). Group A showed the most significant changes in the DTpost (6.1 土 1.2°C, P = 0.021), and the DTnet (6.0 土 1.00C, p = 0.023), as compared to group C.

Conclusions: LSGB showed a similar effect on the VAS, and ODI, and a significant effect, on WD. compared with TFESI. Group A showed a significant sympatholytic effect, as compared to group C. (Korean J Pain 2009; 22: 151-157) Key Words: lumbar sympathetic ganglion block, spread patdterns of contrast, temperature difference, transforaminal epidural steroid injection.