中国骨伤2025，Vol.38Issue(11)：1145-1150,6.DOI:10.12200/j.issn.1003-0034.20250335
脊神经后内侧支阻滞治疗骨质疏松椎体压缩骨折经皮椎体增强术后持续疼痛
Posterior medial branch block for persistent pain after percutaneous vertebral augmentation in osteoporotic vertebral fractures
摘要
Abstract
Objective To evaluate the short-and medium-term efficacy of posterior medial branch block in the treatment of persistent pain after percutaneous vertebral augmentation.Methods From January 2018 to January 2023,a total of 1,062 pa-tients with osteoporotic vertebral compression fractures underwent percutaneous vertebral augmentation.Among them,32 el-derly patients who experienced persistent low back pain after surgery and subsequently received posterior medial branch block and cryoablation were included.Six patients died during follow-up,leaving 26 patients for final analysis(1 male,25 females).The mean age was(82.96±5.66)years(ranged,76 to 94 years).The mean body mass index was(23.76±3.08)kg·m-2(ranged 18.1 to 27.2 kg·m-2).The bone mineral density T-value ranged from-2.5 to-4.3 with a mean of(-3.09±0.56).The mean vol-ume of bone cement injected was 6.00(5.38,7.00)ml.Fracture locations were T11(2 cases),T12(7 cases),L1(10 cases),L2(6 cases),and L3(1 case).The mean interval from vertebral augmentation to block treatment was(7.12±2.22)months(rangd 6 to 12 months).The vertebral augmentation procedures were percutaneous kyphoplasty(PKP)in 12 cases and percutaneous vertebroplasty(PVP)in 14 cases.At the 2nd week,3rd month,and 6th month after the block,the numerical rating scale(NRS),Oswestry disability index(ODI),patient satisfaction,and pain relief rate at the 6th month were evaluated.Relation-ships between pain relief rate at the 6th month after the last treatment and possible influencing factors were analyzed.Results Compared with X-ray films after percutaneous vertebral augmentation,the X-ray films before block showed an increase in kyphotic angle and vertebral compression rate,with statistically significant differences(P＜0.05).At the 2nd week,3rd month,and 6th month after posterior medial branch block and cryoablation,NRS and ODI scores were significantly lower than before the block(P＜0.05).Among the 26 patients,5 received additional cryoablation.At the 6th month after the last treatment,19 pa-tients reported excellent or good satisfaction.Univariate binary Logistic analysis showed all P＞0.05,and no independent factor affecting final satisfaction or pain relief at 6 months after the last treatment was identified.Conclusion Posterior medial branch block(with cryoablation)can effectively improve short-and medium-term symptoms and function in patients with persistent ax-ial low back pain after percutaneous vertebral augmentation for osteoporotic vertebral fractures.关键词
骨质疏松椎体压缩骨折/经皮椎体增强术/残留背痛/内侧支阻滞Key words
Osteoporotic vertebral compression fracture/Percutaneous vertebral augmentation/Residual back pain/Medial branch block分类
医药卫生引用本文复制引用
王喆人,喻任,陆纯德,徐志远,吴彬,倪诚..脊神经后内侧支阻滞治疗骨质疏松椎体压缩骨折经皮椎体增强术后持续疼痛[J].中国骨伤,2025,38(11):1145-1150,6.基金项目
2021年上海市虹口区卫生健康委员会医学科研立项建设计划面上项目(编号:虹卫 2102-25)General Program of the 2021 Medical Research Project Establishment and Construction Plan of the Health Commission of Hongkou District,Shanghai(No.HongWei 2102-25) （编号:虹卫 2102-25）
