Background:Spinal cord cysticercosis, a rare subtype of neurocysticercosis (NCC), primarily affects the subarachnoid space. The optimal treatment approach remains uncertain, with both pharmacological and surgical strategies being employed. Spinal cord stimulation (SCS) has been established as a safe and effective therapy for chronic pain,we present a case of neuropathic pain caused by spinal cord cysticercosis, successfully managed with SCS. Case presentation:A 69-year-old female presented with an 8-year history of trunk and limb pain. Eight years ago, she was diagnosed with spinal cord cysticercosis at a hospital in South Korea and underwent laminectomy. The surgery was uneventful, and her postoperative recovery was satisfactory. However, the pain persisted and progressively worsened over time, eventually involving the entire trunk and limbs, accompanied by sensory abnormalities and progressive lower limb weakness. After a thorough evaluation based on her symptoms, an electrode was placed at the L2 segment for spinal cord stimulation. During hospitalization, stimulation parameters were adjusted multiple times based on patient feedback. At a one-week postoperative follow-up, the patient reported significant relief from trunk and limb pain, along with marked improvement in lower limb strength, sensory perception, numbness, and cold sensations. Conclusions: This case demonstrates the efficacy of SCS in treating neuropathic pain caused by spinal cord cysticercosis. The benefits extend beyond pain relief to include recovery of impaired motor function, providing a valuable reference for managing refractory pain in similar patients.

Purpose of Review Chronic abdominal wall pain is a poorly recognized cause of chronic abdominal pain, and patients frequently go misdiagnosed despite a battery of medical tests. The Carnett’s test is a diagnostic tool used to distinguish between abdominal wall pain and visceral pain. This review synthesizes the current literature on the Carnett’s test, merges the viewpoints of diverse writers, and evaluates and reports on the Carnett’s test’s applicability. Recent Findings Several clinical investigations have established the usefulness of the Carnett’s test in the diagnosis of chronic abdominal wall pain. Furthermore, the Carnett’s test is quite useful in determining the depth of the mass and detecting psychogenic abdominal pain. However, its diagnostic use for acute abdominal pain is limited. Summary The Carnett’s test is a simple and safe point-of-care diagnostic technique, with several studies supporting its usefulness. Early detection of abdominal wall pain is critical for chronic abdominal wall pain therapy. Carnett’s test is very useful in patients with chronic, unexplained local abdominal discomfort who are compliant and do not have a clear rationale for surgery.

Objective:To compare the application effects of ultrasound guidance short axial and long axial incision guidance technique in cervical spinal nerve in patients with short neck.Methods:This study was a randomized controlled study, selected 68 patients with short neck diagnosed with posterior cervical spinal nerve branched pain in the department of Painology of Yanbian University Affiliated Hospital from January 2019 to January 2022, there were 30 males and 38 females, age(46.1±8.1)years old, ranging form 30 to 65 years old.The patients were randomly divided into long axis group and short axis group, with 34 patients in each group.Patients in the short axis group was subjected to posterior medial branch puncture of the cervical spinal nerve under the ultrasound guidance with short axial, and the patients were subjected to posterior medial branch puncture of the cervical spinal nerve under the ultrasound guidance with long axial.The numerical rating scale(NRS), first puncture success rate, puncture failure rate, puncture time, satisfaction, puncture target exposure rate and puncture related complications before and after treatment of both two groups was compared.Results:The success rate of the first puncture in the short axis group [85.3%(29/34)] was significantly higher than that in the long axis group [55.9%(19/34)], the puncture time [(15.2±1.7)s] was significantly less than that of the long axis group [(35.1±2.7)s], and the puncture failure rate [5.9%(2/34)] was lower than that of the long axis group [23.5%(8/34)], the differences were statistically significant( P<0.05). The NRS scores of both two groups were lower at the first day[(4.2±0.2)points, (3.1±0.2)points], third days [(3.9±0.4)points, (2.6±0.3) points], fifth days[(3.6±0.2)points, (2.1±0.4)points] and seventh days[(4.2±0.2)points, (3.1±0.2)points] after treatment than those before treatment[(6.0±0.8)points, (6.1±1.1)points], the differences were statistically significant( P<0.05). The NRS of the short axis group was lower than that of the long axis group, the difference was statistically significant( P<0.05). In the long axis group, the overall exposure rate of the posterior medial spinal nerve targets of C 3, C 4, C 5, C 6, C 7 were 28.6%(2/7), 82.4%(14/17), 90.0%(18 /20), 73.7%(14/19), 33.3%(1/3), 74.2%(49/66), in the short axis, C 3, C 4, C 5, C 6, C 7 spinal patients were 83.3%(5/6), 93.8%(15/16), 95.5%(21/22), 95.0%(19/20), 100%(3/3), 94.0%(63/67). In the short axis group, the posterior medial branch target exposure rate of the C 3, C 4, C 5, C 6, C 7 spinal nerve patients were higher than that of the long axis group, and the overall exposure rate was significantly higher than that of the long axis group, the differences were statistically significant( P<0.05). Patient satisfaction in the short axis group was higher than that in the long axis group, the difference was statistically significant( P<0.05). Complications of patients in the short axis group [0%(0/34)] and [5.8%(2/34)] in the long axis group, the difference was statistically significant( P<0.05). Conclusions:Posteromedial branch puncture of cervical spinal nerve under the ultrasound guidance with short axial is more suitable for patients with short neck, which can significantly shorten the puncture time, improve the success rate of puncture, target exposure rate and patient satisfaction.

Objective:To observe the efficacy and safety of transpleural surface intercostal nerve block with ropivacaine and betamethasone combined with methylene blue for incisional pain after thoracotomy in patients with lung cancer.Methods:Sixty patients with incisional chronic pain after thoracotomy for lung cancer in the Pain Department, Affiliated Hospital of Yanbian University from May 2017 to February 2019 were collected and divided into two groups ( n=30), with diseased course 9-21 months, both sexes, age 52- 79 years old. Patients were treated by 1% ropivacaine 7.5 ml + betamidone 2 mg, diluted to 15 ml with normal saline in Rop group; by 1% ropivacaine 7.5 ml+betamidone 2 mg+methylene blue 2 mg, diluted to 15 ml by normal saline in Rop+MB group. VAS, quality of life scores, opioid dosage were recorded before and at 1 week, 4 weeks, 8 weeks and 12 weeks after the treatment. Efficacy and adverse reactions were observed at 8 weeks and 12 weeks after treatment. Results:The VAS decreased at 1 week, 4 weeks, 8 weeks and 12 weeks after the treatment in both groups compared with that before the treatment, [(4.2±1.7), (4.6±0.8), (5.7±1.1), (5.7±1.1) vs. (7.6±0.8)] respectively in the Rop group, [(4.5±1.3), (4.2±0.7), (3.6±0.6), (2.9±1.0) vs. (7.5±1.0)]respectively in the Rop+MB group (all P<0.05). Compared with pretreatment, the number of patients of VAS 0-3 were increased in both groups after the treatment, while the cases were 12 and 8 at 8 weeks and 12 weeks in the Rop group compared with 24 and 22 in the Rop+MB group (all P<0.05). The GQOLI-74 scores increased in the two groups at 1 week, 4 weeks, 8 weeks and 12 weeks after the treatment, [(49.30±1.60), (83.50±2.70), (57.20±3.10), (47.20±2.10) vs. (26.30±1.50)] in the Rop group respectively, [(48.60±1.54), (82.20±2.60), (88.50±3.61), (94.20±3.31) vs. (25.60±1.90)] respectively in the Rop+MB group (all P<0.05). Compared with Rop group, the dosage of oxycodone hydrochloride tablets were significantly decreased at 8 weeks and 12 weeks after the treatment ( P<0.05). The effective ratio and excellent and good ratio were significantly higher in the Rop + MB group ( P<0.05). No complications such as pneumothorax, chest tightness or dyspnea happened in both groups. Conclusion:Combined methylene blue with ropivacaine and betamethasone extrapleural intercostal nerve block can improve the efficacy of treatment for incisional chronic pain after thoracotomy for lung cancer.

Objective:To observe effects of ultrasound-guided stellate ganglion pulse radiofrequency on the selective nerve root pulse radiofrequency in patients with cervical spondylotic radiculopathy (CSR).Methods:Fifty patients with CSR, aged>55 years old, duration >1 month, numerical rating scale (NRS)≥4, were collected in Department of Painology, Yanbian University Affiliated Hospital from March 1st, 2019 to March 1st, 2020, and the patients were divided into selective nerve root RF group (RF group) and selective nerve root radiofrequency combined with stellate ganglion pulse radiofrequency group (RF combination group) by random number table method, 25 cases in each group. The patients received pulse radiofrequency at C 6 nerve root under ultrasound guidance in the RF group, and received pulse radiofrequency at C 6 nerve root combined with stellate ganglion pulse radiofrequency in the RF combination group. Before the treatment, 1 d, 1 week and 1, 3, 6 and 12 months after the treatment, NRS, numbness score, and CSA-GAS score were recorded. The average blood flow velocity, resistance index, blood flow of the affected brachial artery were recorded before the treatment, 1 week and 1, 3, 6 and 12 months after the treatment. The efficacy was evaluated at 6 and 12 months after the treatment. Complications such as dizziness, numbness and hematoma were observed during the treatment. Results:There was no significant difference in the general data between the two groups (all P>0.05). Compared with pre-treatment, NRS was decreased at each time point after the treatment in the two groups (all P<0.05). NRS was lower in the RF combination group than that in the RF group at 1 week and 1, 3, 6, 12 months after the treatment (all P<0.05). Compared with the RF group, the number of NRS 0-3 points was significantly increased in the RF combination group at 3, 6 and 12 months after the treatment (all P<0.05). Compared with pre-treatment, the numbness score significantly decreased at 1, 3, 6 and 12 months after the treatment in the RF combination group (all P<0.05). Compared with pre-treatment, CSA-GAS significantly increased at 1 week and 1, 3, 6 months after the treatment in the two groups (all P<0.05), and CSA-GAS were higher in the RF combination group than that in the nerve root RF group at all time points (all P<0.05). The average blood flow velocity and blood flow of the affected brachial artery increased at 1, 3, 6 and 12 months after the treatment than that pre-treatment in the RF combination group (all P<0.05); the resistance index decreased (all P<0.05), and the RF combination group was superior to the RF group (all P<0.05). At 12 months after the treatment, the effective and good rate was better in the RF combination group than that in the RF group[92.0% (23/25 cases) vs. 76.0% (19/25 cases), χ2=0.57, P=0.039]. No serious complication reactions were observed in both groups. Conclusion:Stellate ganglion pulse radiofrequency can safely and effectively improve the clinical efficacy of ultrasound-guided selective nerve root pulse radiofrequency in patients with CSR, by improving the blood flow of the affected limb.

Objective:To observe the efficacy of ultrasound-guided silver needle therapy combined with erector spinae plane block in the treatment of patients with spinal degenerative scoliosis deformity-related back pain.Methods:Sixty-nine patients with chronic back pain related to degenerative scoliosis deformity of both sexes, aged 50-70 years old, from March 2019 to March 2021 in the Yanbian University Affiliated Hospital, were randomly divided into silver needle group (ND group), erector spinae plane block group (ESPB group) and combined group (CB group), 23 cases in each group. The patients received ultrasound-guided silver needle treatment on back in the ND group, while received ultrasound-guided ESPB in the ESPB group, and received both methods in the CB group, once a week for 4 consecutive weeks. VAS, SF-36 quality scale of life and ADL scale were recorded before and during the treatment, and 4, 8 and 12 weeks after the treatment. Efficacy was evaluated at 4, 8 weeks after the treatment, and Cobb's angle was measured before and after the treatment. The complications related to the treatment were observed.Results:Compared with pre-treatment, VAS was decreased at each time point during and after the treatment in the ESPB group and CB group (all P<0.05); while VAS was decreased from the 3rd treatment in the ND group (all P<0.05). Compared with ND group, VAS was decreased significantly after the 3rd treatment in the CB group (all P<0.05), and VAS was decreased at the 1st and 2nd treatment in the ESPB group (all P<0.05). At 4, 8 and 12 weeks after the treatment, SF-36 and ADL scores were significantly increased compared with pre-treatment in the 3 groups (all P<0.05), and these scores were higher in the CB group than those in the other two groups (all P<0.05). Compared with pre-treatment, the Cobb's angle was decreased at 4, 8 and 12 weeks after the treatment in all the groups of patients (all P<0.05); the Cobb's angle difference after the treatment increased significantly at 12 weeks in the CB group compared with the ND group and ESPB group (all P<0.05). The total effective rate was higher in the CB group than that in the ND group and ESPB group at 4 and 12 weeks after the treatment ( χ2=8.92, P=0.012; χ2=13.85, P=0.001). No complications, such as infection, pneumothorax, hematoma, and local anesthetic poisoning, were found in all patients. Conclusion:Ultrasound-guided silver needle or erector spinae plane block is effective in the treatment of adult scoliosis degeneration-related back pain, and combination of these two methods is superior to the individual method.

临床上下肢冷觉异常的病例屡见不鲜,其突出表现为下肢发凉、惧冷,即使在炎热的夏季都需要穿秋冬季下衣,令病人苦不堪言.病人经血管外科、风湿科、神经内科和中医科等多学科诊治难以见效.研究报道发现 [1～3]:腰交感神经毁损不仅通过扩张下肢血管、建立侧支循环以改善下肢缺血性和神经病理性疼痛,而且可显著增加下肢的温热、舒适感.目前国内外学者对腰交感神经毁损治疗下肢发凉、惧冷等温度觉异常的临床报告和基础研究甚少.我科采用CT引导下腰交感神经毁损治疗下肢冷觉异常获得良好的疗效.

颈源性头痛 (cervicogenic headache, CEH) 是指颈椎或颈部软组织器质性或功能性病损引起的,以慢性、单侧头部疼痛为主要表现的综合征.随着科技的发展,人们的工作和生活方式发生了巨大改变,导致CEH的发生率逐年上升,并呈明显的年轻化趋势,严重影响病人的工作能力和生活质量 [1].随着疼痛医学的迅速发展,CEH的治疗方法和效果也不断改进.近年来研究报道 [2~4]: 颈2 (C2)背根神经节脉冲射频或颈部硬膜外持续镇痛均可改善CEH的疼痛程度,但单纯一种方法疗效并不十分理想,原因可能是由于CEH的发病机制比较复杂,而单纯一种治疗方法的作用十分局限,不能覆盖所有发病机理所致,给临床医生带来巨大挑战.为进一步提高CEH的治疗效果,有必要观察两种治疗方法联合能否提高CEH的临床疗效.本研究回顾2013年1月至2016年2月我院诊治的CEH病人90例,旨在评价颈部硬膜外持续镇痛联合C2背根节脉冲射频治疗CEH的近期疗效与安全性.

>慢性偏头痛是一类发作性且常为单侧的搏动性头痛,可长期影响患者的生活质量。常规药物治疗效果多不理想。有研究表明,蝶腭神经节脉冲射频治疗难治性的丛集性头痛安全有效,但多在治疗后1周才能起效 [1] 。另有研究表明,蝶腭神经节阻滞可治疗慢性偏头痛,改善生活质量,且起效较快,但需重复治疗,患者往往难以接受 [2] 。本研究拟评价

Pulsed radiofrequency is a new technique developed from the basis of continuous radiofrequency.Pulsed radiofrequency is widely used for the treatment of neuropathic pain due to the merits of low temperature, slight injury, significant effect and repeatable operation.Pulsed radiofrequency in the treatment of zoster-associated pain, trigeminal neuralgia, cervical lumbosacral radicular pain, complex regional pain syndrome and cancerous pain are summarized in this paper, to provide references for clinical application.

目的:观察氟比洛芬酯用于肩关节镜手术超前镇痛的临床效果和安全性.方法:108例拟行肩关节镜手术患者,随机分为三组,超前镇痛组(A组)、常规镇痛组(B组)和对照组(C组).A组于手术开始前15min静脉注射氟比洛芬酯1 mg/kg,B组、C组分别于手术结束前15min静脉注射氟比洛芬酯1mg/kg、生理盐水0.1 mL/kg,所有患者术后均行自控静脉镇痛(PCIA).分别记录三组患者术后各个时间点的视觉模拟疼痛评分(VAS),24h内芬太尼使用量及PCIA使用情况,以及氟比洛芬酯相关不良反应发生情况.结果:A组术后各个时间点的VAS评分明显低于同时间点B、C组评分(P＜0.05).术后24 h芬太尼用量A组明显低于B、C两组(P＜0 01).PCIA留置时间A组明显低于B、C两组P＜0.05).三组各时间点无呼吸抑制、凝血功能异常发生,术后恶心、呕吐等不良反应发生率差异无显著性.结论:氟比洛芬酯超前镇痛能有效减轻肩关节镜患者的术后疼痛,且无明显不良反应,可安全用于患者术后镇痛.