ЭФФЕКТИВНОСТЬ КУПИРОВАНИЯ БОЛИ ПОСЛЕ РАДИОЧАСТОТНОЙ ДЕНЕРВАЦИИ ГЕНИКУЛЯРНЫХ НЕРВОВ ПРИ ГОНАРТРОЗЕ
Bibliographic record
Abstract
Цель. Изучение эффективности и безопасности применения радиочастотной абляции геникулярных нервов при лечении хронической боли на фоне гонартроза Методика. Пилотное проспективное наблюдательное исследование, включающее 31 пациента с гонартрозом, хронической болью в коленном суставе длительностью более 3 месяцев на фоне неэффективной консервативной терапии. Применялась радиочастотная денервация (РЧД) верхнего латерального и медиального и нижнего медиального геникулярных нервов в термическом режиме под флуороскопическим контролем. Изучались интенсивность боли по ВАШ, функция коленного сустава по WOMAC, субъективное восприятие эффективности лечения, осложнения в сроки 1, 3, 6, 12 месяцев. Результаты. Показан значимый стойкий противоболевой эффект: снижение интенсивности боли через 6 и 12 месяцев на 3,97±1,87 и 3,06±1,55 баллов по ВАШ (p<0,001). Через 6 месяцев боль уменьшилась как минимум на 50% у 74% пациентов, 77,4% пациента отмечали улучшение состояния, а среднее снижение по шкале WOMAC составило -19,5 баллов (p<0,001). Осложнений (парестезий, гипестезий, гематом, термических повреждений, инфекций) не выявлено. Заключение. В исследовании показана высокая эффективность и безопасность, стойкий длительный противоболевой эффект радиочастотной денервации при гонартрозе. Objective. To evaluate the efficacy and safety of radiofrequency ablation (RFA) of genicular nerves in symptomatic knee arthritis. Methods. This prospective observational study involved 31 patients with chronic (≥3 months) pain due to knee osteoarthritis that was unresponsive to conservative management. Radiofrequency thermal neurotomy of the genicular nerves was done under fluoroscopy. The outcome measures included visual analog scale (VAS), Western Ontario and McMaster Universities Index (WOMAC) and Likert scale for patient satisfaction and complication rate in the 1st,3rd, 6th and 12th months. Results. Knee pain was reduced significantly: in 6 and 12 months mean VAS score reduction was 3,97±1,87 и 3,06±1,55 when comparing to pretreatment values (p<0,001). Pain relief of 50% or greater was achieved in 74% of patients, improved Global Perceived Effect was observed in 77,4% of cases, mean reduction in WOMAC score was -19,5 (p<0,001). No patient reported procedure-related adverse events (e.g. sensory loss, hematoma, burn or infection). Conclusions. The study demonstrated that RFA is an effective and safe long-term therapeutic option for managing pain and improving physical function in patients with symptomatic knee OA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.004 | 0.008 |
| Scholarly communication | 0.012 | 0.008 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.030 | 0.012 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".