腰背痛神经阻滞疗法课件

腰背痛腰背痛腰背痛的原因腰背痛的原因椎间盘源性椎间盘源性椎间盘源性椎间盘源性 纤维环破裂纤维环破裂纤维环破裂纤维环破裂 髓核压迫纤维环内的髓核压迫纤维环内的髓核压迫纤维环内的髓核压迫纤维环内的c c纤纤纤纤维维维维 炎性因子刺激神经炎性因子刺激神经炎性因子刺激神经炎性因子刺激神经临床特点临床特点临床特点临床特点腰背痛的原因腰背痛的原因小关节源性小关节源性小关节源性小关节源性 小关节功能紊乱小关节功能紊乱小关节功能紊乱小关节功能紊乱 小关节退行性变小关节退行性变小关节退行性变小关节退行性变小关节的神经支配小关节的神经支配小关节的神经支配小关节的神经支配 脊神经背支内侧支脊神经背支内侧支脊神经背支内侧支脊神经背支内侧支临床表现临床表现临床表现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腰背痛的神经阻滞疗法ESI椎间盘源性腰背痛椎间盘源性腰背痛椎间盘源性腰背痛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骶髂关节综合症背痛背痛背痛背痛臀部大腿部疼痛臀部大腿部疼痛臀部大腿部疼痛臀部大腿部疼痛偶尔有类似坐骨神经痛偶尔有类似坐骨神经痛偶尔有类似坐骨神经痛偶尔有类似坐骨神经痛现象现象现象现象不能长时间保持某一坐不能长时间保持某一坐不能长时间保持某一坐不能长时间保持某一坐姿姿姿姿症状复杂，诊断困难症状复杂，诊断困难症状复杂，诊断困难症状复杂，诊断困难骶髂关节体格检查骶髂关节体格检查 Gaenslens Gaenslens test test is is performed performed with with the the patient patient supine supine(on(on the the back).back).The The hip hip joint joint is is maximally maximally flexed flexed on on one one side side and and the the opposite opposite hip hip joint joint is is extended.extended.This This maneuver maneuver stresses stresses both both sacroiliac sacroiliac joints simultaneously.joints simultaneously.骶髂关节体格检查骶髂关节体格检查Yeomans Yeomans test test stresses stresses the the sacroiliac sacroiliac joint joint by by extending extending the the leg leg and and rotating rotating the the ilium.ilium.A A positive positive test test produces produces pain pain over over the the back back of of the sacroiliac joint.the sacroiliac joint.骶髂关节体格检查骶髂关节体格检查Patricks Patricks test test stresses stresses the the hip hip and and sacroiliac sacroiliac joints.joints.A A positive positive test test produces produces back,back,buttocks,or groin pain.buttocks,or groin pain.骶髂关节阻滞骶髂关节阻滞腰腿痛的神经阻滞治疗腰腿痛的神经阻滞治疗椎间盘突出椎间盘突出脊神经根受刺激脊神经根受刺激腰神经根受压的疼痛分布腰神经根受压的疼痛分布腰腿痛的神经阻滞治疗腰腿痛的神经阻滞治疗ESI椎旁神经阻滞椎旁神经阻滞选择性神经根阻滞选择性神经根阻滞selective nerve root block选择性神经根阻滞选择性神经根阻滞selective nerve root blockS1block椎管狭窄、椎间孔狭窄椎管狭窄、椎间孔狭窄椎体滑脱椎体滑脱梨状肌综合症SpinalRegionReferralAreaConditionMimickedUpper Cervical Spine(neck)C1-C4Back of the head(occiput),back of the shoulders,angle of the jaw,faceHeadaches,migraines,jaw problems,trigeminal neuralgia,tension in the shouldersMiddle/Lower Cervical Spine(neck)C5-C8Arms,forearms,hands and fingersTrapped nerve in the neck,tennis elbow,golfers elbow,frozen shoulderUpper Thoracic Spine(above the bra-strap)T1-T4Pain in the arms,front of the upper chest,upper ribsTrapped nerve in the neck,angina,breathing difficulties and other chest complaintsMiddle Thoracic Spine(at the bra-strap)T5-T8Upper abdomen,middle ribsStomach ulcer,gall bladder problems,trapped wind,indigestion,breathing difficulties and other chest complaintsLower Thoracic Spine(below the bra-strap)T9-T12Lower abdomen,lower ribs,pelvis and sexual organsIrritable bowel disorder,pelvic pain,period pain,pain in the sexual organsUpper Lumbar Spine L1-L3Groin,front of the upper thighTrapped nerve in the back,groin and thigh problems,hip and knee problemsLower Lumbar Spine L4-L5Front of the inner and outer shin bone,top of the footSciatica,shin and foot problemsSacrum S1-S4Buttocks,perineumPelvic pain,coccydyniaPainTypeDiagnosisTreatmentSimple Spinal PainSimple Sprain,Muscle Spasm,Segmental Spinal DysfunctionAcupuncture,TENS,Exercises,ManipulationComplex Spinal Pain(in addition to those treatments for Simple Spinal Pain)The Bad SprainLigament SclerosantsFacet Joint SyndromeFacet Joint InjectionsSciaticaEpidural Injections,Nerve Root Blocks,Surgery,EpiduroscopySpondylolisthesisLigament Sclerosants,Facet Joint Injections,Epidural Injections,Nerve Root Blocks,SurgerySpinal StenosisEpidural Injections,SurgeryForaminal StenosisEpidural Injections,Nerve Root Blocks,SurgerySpinal OsteoporosisTrigger Point Injections,VertebroplastyReferred Spinal PainTreatment for the cause of the painFailed Spinal SurgeryFacet Joint Injections,Ligament Sclerosants,Epidural Injections,Nerve Root Blocks,Epiduroscopy,IDET,Intrathecal Morphine PumpNerve PainPeripheral NeuralgiaPeripheral Nerve Blocks,Anti-convulsants,Anti-depressantsSympathetic PainChronic Regional Pain Syndromes,Sympathetically Maintained Pain Sympathetic Blocks,Anti-convulsants,Anti-depressants神经损毁神经损毁目的目的外周神经损毁外周神经损毁物理损毁物理损毁物理损毁物理损毁 射频射频射频射频化学损毁化学损毁化学损毁化学损毁 无水酒精、酚无水酒精、酚无水酒精、酚无水酒精、酚PAIN 结束语当你尽了自己的最大努力时，失败也是伟大的，所以不要放弃，坚持就是正确的。When You Do Your Best,Failure Is Great,So DonT Give Up,Stick To The End谢谢大家荣幸这一路，与你同行ItS An Honor To Walk With You All The Way演讲人：XXXXXX 时 间：XX年XX月XX日