腰背痛神经阻滞疗法.ppt

腰背痛,腰背痛的原因,椎间盘源性纤维环破裂髓核压迫纤维环内的c纤维炎性因子刺激神经临床特点,腰背痛的原因,小关节源性小关节功能紊乱小关节退行性变小关节的神经支配脊神经背支内侧支临床表现,小关节源性腰背疼痛的疼痛分布范围,腰背痛的神经阻滞疗法,ESI,椎间盘源性腰背痛,腰椎小关节注射、内侧支阻滞,腰椎小关节注射、内侧支阻滞,骶髂关节综合症,背痛臀部大腿部疼痛偶尔有类似坐骨神经痛现象不能长时间保持某一坐姿症状复杂，诊断困难,骶髂关节体格检查,Gaenslens test is performed with the patient supine(on the back).The hip joint is maximally flexed on one side and the opposite hip joint is extended.This maneuver stresses both sacroiliac joints simultaneously.,骶髂关节体格检查,Yeomans test stresses the sacroiliac joint by extending the leg and rotating the ilium.A positive test produces pain over the back of the sacroiliac joint.,骶髂关节体格检查,Patricks test stresses the hip and sacroiliac joints.A positive test produces back,buttocks,or groin pain.,骶髂关节阻滞,腰腿痛的神经阻滞治疗,椎间盘突出,脊神经根受刺激,腰神经根受压的疼痛分布,腰腿痛的神经阻滞治疗,ESI,椎旁神经阻滞,选择性神经根阻滞selective nerve root block,选择性神经根阻滞selective nerve root block,S1block,椎管狭窄、椎间孔狭窄,椎体滑脱,梨状肌综合症,神经损毁,目的外周神经损毁物理损毁射频化学损毁无水酒精、酚,