经皮椎体成形术联合脊神经后支阻滞治疗骨质疏松性椎体压缩骨折合并腰骶筋膜损伤的短期疗效分析  

Short-term efficacy of percutaneous vertebroplasty combined with posterior branch block of spinal nerve in treatment of patients with osteoporotic vertebral compression fractures combined with lumbosacral fascia injury

作　　者：孙海波 张双江 侍管 陈萌萌[1] 唐海[1] SUN Haibo;ZHANG Shuangjiang;SHI Guan;CHEN Mengmeng;TANG Hai(Department of Orthopedics,Beijing Friendship Hospital Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院骨科中心,北京100050

出　　处：《中国骨与关节损伤杂志》2025年第1期24-27,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的 观察经皮椎体成形术联合脊神经后支阻滞治疗骨质疏松性胸腰段椎体压缩骨折合并腰骶筋膜损伤的短期疗效。方法 回顾性病例对照研究纳入自2021-07-2022-12诊治的60例骨质疏松性胸腰段椎体压缩骨折合并腰骶筋膜损伤,A组30例采用单纯经皮椎体成形术治疗,B组30例采用经皮椎体成形术联合脊神经后支阻滞治疗。比较两组手术时间、术中X线透视次数、骨水泥注入量、骨水泥弥散情况,以及术后1周、术后1个月腰背部疼痛VAS评分。结果 60例手术均顺利完成,无神经血管损伤、骨水泥渗漏压迫椎管、骨水泥渗漏导致的肺栓塞等严重并发症发生。B组手术时间较A组长,术中X线透视次数较A组多,差异有统计学意义(P<0.05)。A组与B组骨水泥注入量、骨水泥弥散状态差异无统计学意义(P>0.05)。A组术后1周疼痛VAS评分为(2.70±1.06)分,术后1个月为(1.47±0.86)分;B组术后1周疼痛VAS评分为(2.07±0.91)分,术后1个月为(1.07±0.52)分。B组术后1周、术后1个月疼痛VAS评分低于A组,差异有统计学意义(P<0.05)。结论 经皮椎体成形术联合脊神经后支阻滞治疗骨质疏松性胸腰段椎体压缩骨折合并腰骶筋膜损伤可以有效缓解急性疼痛,改善患者术后早期的脊柱功能。Objective To observe the short-term effect of percutaneous vertebroplasty combined with posterior spinal nerve block in the treatment of thoracolumbar osteoporotic vertebral compression fractures combined with lumbosacral fascia injury.Methods A retrospective case-control study included 60 cases of thoracolumbar osteoporotic vertebral compression fractures with lumbosacral fascia injury treated from July 2021 to December 2022.Thirty cases in group A were treated with percutaneous vertebroplasty alone,and 30 cases in group B were treated with percutaneous vertebroplasty combined with posterior spinal nerve block.The operation time,intraoperative X-ray fluoroscopy,the amount of cement injected,the dispersion of cement,and the VAS score of low back pain at 1 week and 1 month after operation were compared between the two groups.ResultsAll the oper-ations were successfully completed without severe complications such as neurovascular injury,vertebral canal compression and pulmonary embolism caused by cement leakage.The operation time of group B was longer than that of group A,and the number of intraoperative X-ray fluoroscopy was more than that of group A,the difference was statistically significant(P<0.05).There was no significant difference in the amount of cement injected and the dispersion of cement between group A and group B(P>0.05).The VAS score in group A was(2.70±1.06)at 1 week and(1.47±0.86)at 1 month after operation;The VAS score in group B was(2.07±0.91)at 1 week and(1.07±0.52)at 1 month after operation.The VAS scores of group B at 1 week and 1 month after operation were lower than those of group A,the dfference was statistically significant(P<0.05).Conclusion Percutaneous ver-tebroplasty combined with posterior spinal nerve block in the treatment of thoracolumbar osteoporotic vertebral compression frac-tures combined with lumbosacral fascia injury can effectively relieve acute pain and improve early postoperative spinal function.

关 键 词：骨质疏松性椎体压缩骨折 腰骶筋膜损伤 经皮椎体成形术 脊神经后支阻滞 

分 类 号：R687.3[医药卫生—骨科学]