经皮椎体成形术联合关节突阻滞治疗骨质疏松性胸腰段椎体骨折所致远端腰骶部疼痛的疗效  

Clinical effect of percutaneous vertebroplasty combined with facet joint block in treating distal lumbosacral pain caused by osteoporotic thoracolumbar vertebral fractures

作　　者：姜嘉伟 徐冠华[1] 李卫东[1] 陈佳佳[1] 张金龙[1] 洪鸿翔 吴春帅 崔志明[1] JIANG Jiawei;XU Guanhua;LI Weidong(Department of Spine Surgery,the Second Affiliated Hospital of Nantong University,Nantong,226001,China)

机构地区：[1]南通大学第二附属医院脊柱外科,南通市226001

出　　处：《中国脊柱脊髓杂志》2024年第10期1061-1067,共7页Chinese Journal of Spine and Spinal Cord

基　　金：南通市科学技术局项目(MS22021008);南通市卫生健康委项目(QN2023019,MSZ2022017);南通大学临床医学专项(2023HY002)。

摘　　要：目的:评价经皮椎体成形术(percutaneous vertebroplasty,PVP)联合关节突阻滞(facet joint block,FJB)治疗骨质疏松性胸腰段椎体骨折(osteoporotic thoracolumbar vertebral fracture,OTVF)所致远端腰骶部疼痛(distal lumbosacral pain,DLP)的疗效。方法:回顾性分析我院2022年1月~2023年7月OTVF伴DLP患者80例。按治疗方式将患者分为PVP组[n=40,男7例,女33例,年龄75.2±6.0(65~89)岁]和PVP联合FJB(PVP+FJB)组[n=40,男11例,女29例,年龄76.6±6.6(62~89)岁]。观察并比较两组患者并发症发生情况。术后1d、1个月、6个月使用视觉模拟量表(visual analogue scale,VAS)评分及Oswestry功能障碍指数(Oswestry disability index,ODI)对患者的疼痛程度及生活质量进行评估。结果:所有患者均顺利完成手术,无并发症发生,并完成7.2±2.6个月(3~12个月)随访。两组患者术后VAS评分及ODI均较术前好转,差异均有统计学意义(P<0.05);术后1d和1个月时PVP+FJB组VAS评分及ODI较PVP组均好转明显,差异有统计学意义(P<0.05),术后6个月两组间差异无统计学意义(P>0.05)。结论:PVP联合FJB治疗OTVF所致DLP具有良好的临床疗效。Objectives:To evaluate the efficacy of percutaneous vertebroplasty(PVP)combined with facet joint block(FJB)in treating distal lumbosacral pain(DLP)in patients with osteoporotic thoracolumbar vertebral fractures(OTVF).Methods:A retrospective analysis was conducted on 80 patients with OTVF accompanied with DLP treated in our hospital from January 2022 to July 2023.Among the patients,40 were treated with PVP(PVP group),including 7 males and 33 females,aged 75.2±6.0(65-89)years old;And 40 were treated with PVP and FJB(PVP+FJB group),including 11 males and 29 females,aged 76.6±6.6(62-89)years old.The complications were observed and compared between the two groups.The visual analogue scale(VAS)score and Oswestry disability index(ODI)were analyzed and compared preoperatively and at 1d,1 month,and 6 months postoperatively to assess the pain status and quality of life of the patients.Results:All the patients successfully completed operation without complictions.The follow-up period ranged from 3 to 12 months,with an average of 7.2±2.6 months.The VAS score and ODI were improved in both groups after operation,and the differences compared with before operation were statistically significant(P<0.05).At postoperative 1d and 1 month,the PVP+FJB group showed significant improvement in VAS score and ODI comparing to the PVP group,with statistically significant differences(P<0.05).However,at 6 months postoperatively,there was no statistically significant difference in VAS score and ODI between the two groups(P>0.05).Conclusions:PVP combined with FJB has a good clinical effect in the treatment of OTVF with DLP.

关 键 词：经皮椎体成形术 胸腰段椎体骨折 腰骶部疼痛 骨质疏松 远隔疼痛 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]