骨质疏松性椎体压缩性骨折微创介入治疗研究进展  

The progress in minimally invasive interventional treatment of osteoporotic vertebral compression fracture

作　　者：张雪轩 鄢毅[1,2,3] 邹欢 陈子明 尹青华 钟凯 曾琳钰 张学学 ZHANG Xue-xuan;YAN Yi;ZOU Huan;CHEN Zi-ming;YIN Qing-hua;ZHONG Kai;ZENG Lin-yu;ZHANG Xue-xue(Department of Pain Medicine,the First Affiliated Hospital of Nanchang University;Jiangxi Provincial Key Laboratory of Trauma,Burn and Pain Medicine;Key Laboratory of Neuropathic Pain(the First Affiliated Hospital of Nanchang University),Healthcare Commission of Jiangxi Province,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院疼痛科 [2]江西省创烧伤及疼痛重点实验室 [3]江西省卫生健康委员会神经性疼痛重点实验室,南昌330006

出　　处：《中国疼痛医学杂志》2025年第3期208-213,221,共7页Chinese Journal of Pain Medicine

基　　金：国家自然科学基金(82360235);江西省重点研发计划(20232BBG70027);江西省自然科学基金(20224ACB206019)。

摘　　要：骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)临床上较为常见,当保守治疗难以缓解病人症状时,可以选择手术治疗。经皮椎体成形术(percutaneous vertebroplasty,PVP)和经皮后凸成形术(percutaneous kyphoplasty,PKP)作为临床上两种经典术式,疗效确切,广泛应用于OVCF的治疗,但是这两种手术一直存在骨水泥渗漏的问题。近年来随着射频镇痛技术的发展,脊神经后支射频消融联合神经阻滞(radiofrequency ablation combined with nerve block,RFNB)应用于OVCF的治疗也取得了较好的疗效。而对某些特殊形态OVCF,经皮椎弓根螺钉内固定术相对传统开放手术优势明显。对于临床医师而言,应该注重OVCF病人个体差异,从而制订个体化的治疗方案,并加强OVCF病人术后康复及护理,并对现有技术不断改进,为OVCF病人提供更好的治疗选择。本文就这4种微创手术治疗OVCF的临床应用及研究进展加以综述,从而为临床工作提供参考。Osteoporotic vertebral compression fracture(OVCF)is clinically common,and surgery is an option when patients are refractory to conservative treatment.Percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)are two classic clinical procedures with definite efficacy and are widely used in the treatment of OVCF,but these two surgeries have always had the problem of cement leakage.In recent years,with the development of radiofrequency analgesic technology,radiofrequency ablation combined with nerve block(RFNB)of the posterior branch of the spinal nerve has also achieved good results in the treatment of OVCF.For some special forms of OVCF,percutaneous pedicle screw fixation has obvious advantages over traditional open surgery.For clinicians,it is necessary to pay attention to the individual differences of OVCF patients,so as to formulate individualized treatment plans,strengthen the postoperative rehabilitation and care of OVCF patients,and continuously improve the existing technology to provide better treatment options for OVCF patients.This article reviews the clinical application and research progress of these four minimally invasive surgeries in the treatment of OVCF,in order to provide reference for clinical work.

关 键 词：骨质疏松性椎体压缩性骨折 微创手术 经皮椎体成形术 经皮后凸成形术 射频消融联合神经阻滞 经皮椎弓根螺钉内固定术 

分 类 号：R687.3[医药卫生—骨科学]