Reflections on Innovative Interventional Pain-Relieving Procedures: Lessons Learned from Previous Mistakes.
Reflections on Innovative Interventional Pain-Relieving Procedures: Lessons Learned from Previous Mistakes.
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对创新介入止痛手术的反思：从以前的错误中吸取的教训。
DOI：
10.1093/pm/pnz380
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Cohen,StevenP
中科院分区：
文献类型：
--
作者：
Zhao,Zirong;Larkin,ThomasM;Cohen,StevenP
肩部是人体最复杂的关节之一，具有潜在的疼痛产生源，例如盂肱关节和肩锁关节、多个滑囊以及包括多个肌腱和肌肉在内的众多软组织结构。肩痛的终生患病率估计为 7% 至 67%，患病率的差异源于研究人群和诊断标准的差异 [1]。据一些消息来源称，肩峰下撞击综合征引起的疼痛是慢性肩部疼痛最常见的原因[2]，尽管许多患者因多种病理原因而疼痛，有些患者尽管放射学病理很少或没有，但仍会疼痛。在美国，慢性肩部疼痛的估计费用很大程度上未知，尽管每年仅在肩袖撕裂的评估和治疗上就花费 30 亿美元[3]。在澳大利亚，每位慢性肩痛患者的平均每年费用估计为 AU $22,378 [4]。然而，尽管肩痛的患病率很高且经济支出很高，但手术和非手术治疗的特点是失败率很高。根据一项系统评价，肩部撞击综合征的手术和非手术治疗在疼痛或功能结果上没有差异[5]。
The shoulder is one of the most complex joints in the body, with potential pain generators such as the glenohumeral and acromioclavicular joints, multiple bursae, and numerous soft tissue structures to include multiple tendons and muscles. The lifetime prevalence of shoulder pain is estimated at 7% to 67%, with the prevalence variation stemming from differences in study populations and diagnostic criteria [1]. According to some sources, pain arising from subacromial impingement syndrome is the most common source of chronic shoulder pain [2], though many patients have pain from multiple pathologies and some have pain despite minimal or no radiologic pathology.In the United States, the estimated cost of chronic shoulder pain is largely unknown, though $3 billion dollars are spent each year on the evaluation and management of rotator cuff tears alone [3]. In Australia, the average annual cost per patient with chronic shoulder pain has been estimated at AU $22,378 [4]. Yet, despite the high prevalence and economic expenditures on shoulder pain, surgical and nonsurgical treatments are characterized by high failure rates. According to one systematic review, there is no difference in pain or functional outcomes between surgical and nonsurgical management for shoulder impingement syndrome [5].