椎体后凸成形术中高温去神经机制对缓解腰背部疼痛的作用  

Role of high temperature denervation in pain relief during percutaneous kyphoplasty

作　　者：徐瑞生[1] 卢海丹[1] 钱宏[1] 袁凤来[1] 

机构地区：[1]南通大学第三附属医院,无锡市第三人民医院骨科,214041

出　　处：《中华创伤杂志》2015年第10期903-906,共4页Chinese Journal of Trauma

基　　金：国家自然科学基金面上资助项目（81270011）;江苏省“333”人才工程培养基金资助项目

摘　　要：目的探讨椎体后凸成形术（PKP）中高温去神经机制对缓解椎体骨质疏松性骨折后腰背部疼痛的作用。方法按照注入聚甲基丙烯酸甲酯（PMMA）在聚合过程中是否给予降温措施，将56例因单椎体骨折行PKP治疗的患者按随机数字表法分为降温组和高温组，每组28例。比较两组患者手术时间、填充物的注入量、手术前后视觉模拟评分（VAS）及Oswestry功能障碍指数（ODI）、术前术后椎体前缘高度变化。结果降温组和高温组的手术时间、PMMA注入量、术后VAS、术后ODI评分和椎体前缘高度恢复率分别为（45．6±7．3）min：（43．6±5．8）min、（2．8±0．3）ml：（2．7±0．4）ml、（3．8±0．7）分：（3．2±0．7）分、（36．6±8．2）分：（30．4±6．0）分、（85．3±6．1）％：（83．9±7．3）％（P均〉0．05）。结论高温去神经机制对PKP手术缓解腰背部疼痛的贡献并不大，疼痛缓解更多是由于椎体的强化和固定。Objective To determine the effect of high temperature denervation in back pain relief during percutaneous kyphoplasty （PKP） for vertebral osteoporotie fracture. Methods Fifty-six patients undergone PKP for single vertebral osteoporotie fracture were randomly divided into cooling group and normal group with 28 patients per group according to whether the temperature reducing measures were provided during the polymerization process of polymethyl methaerylate （PMMA）. Data recorded were operation time, amount of PMMA injected into each vertebral body, visual analogue scale （ VAS ） , Oswestry disability index （ ODI）, and anterior vertebral height. Results All the data revealed no significant differences between cooling and normal groups： operation time [ （45.6 ± 7.3 ）rain vs （43.6 ± 5.8 ） min ], PMMA injected into each vertebral body [ （2.8 ± 0.3） ml vs （2.7 ± 0.4） ml ], VAS [ （3.8± 0.7） points vs （3.2 ± 0.7） points ], ODI [ （36.6 ± 8.2 ） points vs （ 30. 4 ± 6.0 ） points ] and height restoration of anterior vertebral body [（85.3 ± 6.1）% vs （83.9 ± 7.3）%] （P 〉 0.05）. Conclusion High temperature denervation contributes a little to the relief of back pain during PKP, as may be due to the vertebral augmentation and stabilization.

关 键 词：脊柱骨折 骨质疏松 聚甲基丙烯酸类 经皮椎体后凸成形术 

分 类 号：R687.3[医药卫生—骨科学]