{"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\/ro\/policy-for-medical-branch-block-and-facet-joint-injection\/","title":{"rendered":"Politica pentru blocul ramurilor medicale \u0219i injec\u021bia articular\u0103 a fa\u021betelor"},"content":{"rendered":"

Categoria<\/strong><\/p>\n\n\n\n

Criterii de prag<\/p>\n\n\n\n

Durerea de spate non-radicular\u0103 (niciuna radiant\u0103) este cea mai frecvent\u0103 prezentare clinic\u0103. Uneori este denumit\u0103 \u201edureri mecanice de spate\u201d. Este adesea diagnosticul pentru simptome care nu sunt cauzate de un impact neuronal sau de alte cauze semnificative din punct de vedere medical.<\/p>\n\n\n\n

Institutul Na\u021bional de Excelen\u021b\u0103 Clinic\u0103 (NICE) este clar \u00een \u00eendrum\u0103rile sale c\u0103 injec\u021biile cu steroizi intra-articulare fa\u021betare nu trebuie utilizate \u00een tratamentul durerii care provin din articula\u021biile fa\u021betelor lombare. Cu toate acestea, exist\u0103 c\u00e2teva ocazii \u00een care pot fi luate \u00een considerare injec\u021biile articulare cu fa\u021bete. Acestea sunt detaliate mai jos.<\/p>\n\n\n\n

\u00cen conformitate cu Calea durerii de spate LLR, toate trimiterile vor trece prin triajul MSK \u0219i vor fi evaluate de un medic de familie cu interese speciale (GPwSI) sau de un fizioterapeut cu scop \u00eembun\u0103t\u0103\u021bit.<\/p>\n\n\n\n

Eligibilitate<\/strong><\/p>\n\n\n\n

LLR ICB va finan\u021ba blocuri de ramuri mediale pentru gestionarea durerilor de spate cervicale, toracice \u0219i lombare \u00een urm\u0103toarele situa\u021bii clinice<\/strong>

Procedura de diagnostic care duce la denervarea prin radiofrecven\u021b\u0103 a ramului medial dac\u0103 diagnosticul
blocul este pozitiv

\u0218I<\/strong>

Toate op\u021biunile de management conservator au fost \u00eencercate \u0219i au e\u0219uat
\u2013 kinetoterapie
- exerci\u021biu
\u2013 farmacoterapie inclusiv analgezie

\u00a0\u0218I<\/strong>

Durerea a avut ca rezultat un impact moderat p\u00e2n\u0103 la semnificativ asupra vie\u021bii de zi cu zi

SAU<\/strong>

Dac\u0103 blocul ini\u021bial de ramur\u0103 medial\u0103 a avut un beneficiu terapeutic dovedit, dar pacientul nu este potrivit pentru denervarea cu radiofrecven\u021b\u0103 sau pentru un program de management al durerii (de exemplu, comorbidit\u0103\u021bi multiple, disfunc\u021bie cardiac\u0103 \u0219i respiratorie, stimulator cardiac sau alt stimulator nervos, sau fragil \u0219i v\u00e2rstnic)<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
LLR ICB va finan\u021ba injec\u021biile articulare fa\u021bete \u00een urm\u0103toarele situa\u021bii<\/strong>
\u00a0
\u2013 La pacien\u021bii care au avut un rezultat pozitiv de la o injec\u021bie anterioar\u0103

\u2013 Pacien\u021bii v\u00e2rstnici sau cei cu comorbidit\u0103\u021bi la care pozi\u021bionarea pentru denervarea cu radiofrecven\u021b\u0103 este dificil\u0103 din punct de vedere tehnic

\u2013 Pacien\u021bi care au probleme anatomice semnificative unde localizarea nervului prezint\u0103 un risc pentru pacient
<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

\u00cendrumare <\/strong><\/p>\n\n\n\n

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

Category Threshold Criteria Non-radicular (none radiating) back pain is the commonest clinical presentation. Sometimes it is referred to as \u201cmechanical back pain\u201d. 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