{"id":14040,"date":"2023-11-10T14:55:57","date_gmt":"2023-11-10T14:55:57","guid":{"rendered":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/?p=14040"},"modified":"2023-11-10T14:56:01","modified_gmt":"2023-11-10T14:56:01","slug":"policy-for-medical-branch-block-and-facet-joint-injection","status":"publish","type":"post","link":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/policy-for-medical-branch-block-and-facet-joint-injection\/","title":{"rendered":"Zasady dotycz\u0105ce blokowania odga\u0142\u0119zie\u0144 medycznych i wstrzykiwa\u0144 do staw\u00f3w mi\u0119dzywyrostkowych"},"content":{"rendered":"

Kategoria<\/strong><\/p>\n\n\n\n

Kryteria progowe<\/p>\n\n\n\n

Najcz\u0119stszym objawem klinicznym jest niekorzeniowy (nie promieniuj\u0105cy) b\u00f3l plec\u00f3w. Czasami okre\u015bla si\u0119 go mianem \u201emechanicznego b\u00f3lu plec\u00f3w\u201d. Cz\u0119sto diagnozuje si\u0119 objawy, kt\u00f3re nie s\u0105 spowodowane uszkodzeniem uk\u0142adu nerwowego lub innymi przyczynami istotnymi z medycznego punktu widzenia.<\/p>\n\n\n\n

Narodowy Instytut Doskona\u0142o\u015bci Klinicznej (NICE) jasno stwierdza, \u017ce w leczeniu b\u00f3lu pochodz\u0105cego ze staw\u00f3w l\u0119d\u017awiowych nie nale\u017cy stosowa\u0107 \u015br\u00f3dstawowych zastrzyk\u00f3w steroidowych do staw\u00f3w mi\u0119dzywyrostkowych. Istnieje jednak kilka sytuacji, w kt\u00f3rych mo\u017cna rozwa\u017cy\u0107 zastrzyki do staw\u00f3w mi\u0119dzywyrostkowych. Poni\u017cej opisano je szczeg\u00f3\u0142owo.<\/p>\n\n\n\n

Zgodnie ze \u015bcie\u017ck\u0105 leczenia b\u00f3lu plec\u00f3w LLR wszystkie skierowania przejd\u0105 selekcj\u0119 MSK i zostan\u0105 ocenione przez lekarza pierwszego kontaktu ze specjalnymi zainteresowaniami (GPwSI) lub fizjoterapeut\u0119 o rozszerzonym zakresie.<\/p>\n\n\n\n

Uprawnienia<\/strong><\/p>\n\n\n\n

LLR ICB sfinansuje blokady odga\u0142\u0119zie\u0144 przy\u015brodkowych w leczeniu b\u00f3lu plec\u00f3w w odcinku szyjnym, piersiowym i l\u0119d\u017awiowym w nast\u0119puj\u0105cych sytuacjach klinicznych<\/strong>

Procedura diagnostyczna prowadz\u0105ca do odnerwienia ga\u0142\u0119zi przy\u015brodkowej za pomoc\u0105 cz\u0119stotliwo\u015bci radiowych
blok jest pozytywny

I<\/strong>

Wszystkie konserwatywne opcje zarz\u0105dzania zosta\u0142y wypr\u00f3bowane i zawiod\u0142y
\u2013 fizjoterapia
- \u0107wiczenia
\u2013 farmakoterapia obejmuj\u0105ca analgezj\u0119

\u00a0I<\/strong>

B\u00f3l ma umiarkowany lub znacz\u0105cy wp\u0142yw na codzienne \u017cycie

LUB<\/strong>

Je\u015bli pocz\u0105tkowy blok odnogi przy\u015brodkowej przyni\u00f3s\u0142 udowodnion\u0105 korzy\u015b\u0107 terapeutyczn\u0105, ale pacjent nie kwalifikuje si\u0119 do odnerwienia pr\u0105dem o cz\u0119stotliwo\u015bci radiowej lub programu leczenia b\u00f3lu (np. liczne choroby wsp\u00f3\u0142istniej\u0105ce, dysfunkcja serca i uk\u0142adu oddechowego, rozrusznik serca lub inny stymulator nerw\u00f3w, s\u0142aby organizm i osoby starsze)<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
LLR ICB sfinansuje zastrzyki do staw\u00f3w mi\u0119dzywyrostkowych w nast\u0119puj\u0105cych sytuacjach<\/strong>
\u00a0
\u2013 U pacjent\u00f3w, u kt\u00f3rych wynik poprzedniego wstrzykni\u0119cia by\u0142 pozytywny

\u2013 Pacjenci w podesz\u0142ym wieku lub z chorobami wsp\u00f3\u0142istniej\u0105cymi, u kt\u00f3rych ustawienie w celu odnerwienia cz\u0119stotliwo\u015bci\u0105 radiow\u0105 jest technicznie trudne

\u2013 Pacjenci, u kt\u00f3rych wyst\u0119puj\u0105 istotne problemy anatomiczne, w przypadku kt\u00f3rych umiejscowienie nerwu stwarza ryzyko dla pacjenta
<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Przewodnictwo <\/strong><\/p>\n\n\n\n

https:\/\/www.nice.org.uk\/guidance\/ng59<\/a><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
Data przegl\u0105du ARP 71: 2026 r<\/td><\/tr><\/tbody><\/table><\/figure>","protected":false},"excerpt":{"rendered":"

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