29例颈源性肘痛的诊断与治疗
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R745.4 R681.7

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上海市医学领先专业重点学科基金资助(编号993015)


DIAGNOSIS AND TREATMENT OF CERVICAL-DERIVED ELBOW PAIN IN 29 PATIENTS
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    摘要:

    目的:探讨肘外侧疼痛与椎孔外颈神经根(5~7)卡压的关系。方法:对29例肘外侧疼痛同时伴有同侧颈部疼痛或压痛的患者进行治疗及分析:(1)24例接受了同侧颈部固定压痛点局封,封闭点一般位于胸锁乳突肌后缘中点,深达颈椎横突。(2)5例上干型胸廓出口综合征(ThoracicOutlet Syndrom,TOS)同时伴有同侧肘外侧疼痛的病人,进行臂丛神经松解加前、中、小斜角肌切断,并观察肘外侧疼痛缓解的效果。以上病例随访6~24个月。结果:24例患者经颈部压痛点阻滞后,13例疼痛及压痛完全消失,6例压痛明显减轻,2例略有缓解,3例无缓解。5例TOS患者,术后4例完全缓解,1例仍有轻度疼痛及压痛。结论:部分肘外侧疼痛可能是因椎孔外颈神经根(5~7)卡压所致。

    Abstract:

    Objective: To investigate the relationship between resistant lateral elbow pain and cervical nerve roots (5~7) compression. Methods:Twenty-nine cases of patients who complained cervico-brachi-al neuralgia or neck-should-pain were treated and analysed: 1. Twenty-four patients received local block at the pain side of the neck. 2. Five lateral elbow pain patients who were diagnosed Thoracic Outlet Syn-drom(TOS) (Tipe of upper trunk) received brachial plexus neurolysis and scolinus recection. All patients were follow-up for 6 ~ 24 monthes. Results: Lateral elbow pain and tenderness of the 29 patients dissap-peard or relieved. Completely disappeared in 13 eases. Relieved obviously in 6 cases. Slightly relieved in 2 cases. Pain remained in 3 cases. Of all the 5 patients with TOS, pain and tenderness disappeared in 4. Conclusions: Some resistant lateral elbow pain maybe caused by neck nerve roots (5 ~7) compression.

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薛锋 Wiman.29例颈源性肘痛的诊断与治疗[J].中国疼痛医学杂志,2002,8(2):80~82

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