超声引导髂腰肌肌腱松解：尸体调查,PM&R

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超声引导髂腰肌肌腱松解：尸体调查
PM&R ( IF 2.2 ) Pub Date : 2020-08-20 , DOI: 10.1002/pmrj.12430
Wade O Johnson ₁ , Jacob L Sellon ₂ , Brittany J Moore ₂ , Bruce A Levy ₃ , Nirusha Lachman ₄ , Jonathan T Finnoff ₂

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介绍髂腰肌是髋关节前部疼痛的常见来源。难治性病例可能需要手术干预，据报道并发症发生率为 3-50%。开发一种微创的门诊髂腰肌肌腱松解方法是可取的，并且可以降低成本、降低并发症并缩短恢复时间。目的描述和评估在尸体模型中使用脊柱针进行超声引导 (USG) 髂腰肌肌腱松解的安全性和可重复性。研究设计前瞻性尸体实验室调查设置：学术机构程序技能实验室对象：5 个未经防腐处理的尸体标本（3 名女性，2 名男性），年龄 69-93 岁（平均 83.2 岁），体重指数 (BMI) 为 19.2- 30.3 公斤/平方米（平均 24.5 公斤/平方米）。干预措施 2 位操作者各进行了 5 次 USG 髂腰肌肌腱松解。另外三名研究人员解剖骨盆以评估肌腱释放的完整性和对相邻结构的损坏。主要观察指标成功的横断、肌腱横断的完整性(%)、相邻结构的损伤和手术时间。结果 10 次释放中有 9 次达到了 ≥75% 肌腱横断的目标释放。一种程序实现了 50% 的肌腱释放。未发现对相邻结构的损伤。手术的平均持续时间为 6.19 分钟。结论 USG 髂腰肌肌腱松解术可以在尸体模型中进行，始终达到理想的肌腱松解率，不会对邻近的神经血管结构造成损伤，并且需要大约 6 分钟才能完成。虽然结果不能推广到临床环境，但由于该程序的微创性质，该程序很可能可以在局部麻醉下的门诊环境中安全地进行，成本更低，并且有助于更快地恢复与标准外科手术相比，尽管需要进一步研究以用于临床应用。本文受版权保护。版权所有。

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Ultrasound‐Guided Iliopsoas Tendon Release: A Cadaveric Investigation

INTRODUCTION The iliopsoas is a common source of anterior hip pain. Refractory cases may require surgical intervention, with reported complication rates ranging from 3-50%. Development of a minimally-invasive, outpatient method of iliopsoas tendon release is desirable and may reduce costs, lower complications, and improve recovery time. OBJECTIVE To describe and evaluate the safety and reproducibility of an ultrasound-guided (USG) iliopsoas tendon release using a spinal needle in a cadaveric model. STUDY DESIGN Prospective, cadaveric laboratory investigation SETTING: Academic Institution Procedural Skills Laboratory SUBJECTS: 5 unembalmed cadaveric specimens (3 female, 2 male), aged 69-93 yr old (mean 83.2 yr), with body mass indices (BMI) of 19.2-30.3 kg/m2 (mean 24.5 kg/m2). INTERVENTIONS 2 operators each performed 5 USG iliopsoas tendon releases. Three additional investigators dissected the pelves to assess completeness of tendon release and damage to adjacent structures. MAIN OUTCOME MEASURES Successful transection, completeness (%) of the tendon transection, damage to adjacent structures, and procedural time. RESULTS 9 of 10 releases achieved the target release of ≥75% tendon transection. One procedure achieved 50% tendon release. No injury to adjacent structures was identified. The mean duration of the procedure was 6.19 min. CONCLUSIONS USG iliopsoas tendon release can be performed in a cadaveric model, consistently achieve the desired percentage of tendon release, does not result in injury to adjacent neurovascular structures, and takes approximately 6 min to perform. While results cannot be generalized to a clinical setting, due to the minimally-invasive nature of the procedure, it is likely that this procedure can be performed safely in an outpatient setting under local anesthesia, will cost less, and will facilitate a more rapid recovery when compared to standard surgical procedures though further research is warranted for clinical application. This article is protected by copyright. All rights reserved.

更新日期：2020-08-20

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