经皮椎体成形术联合椎旁神经阻滞对老年骨质疏松椎体压缩性骨折患者疼痛、关节功能的影响

Effects of percutaneous vertebroplasty combined with paravertebral nerve block on pain and joint function in elderly patients with osteoporotic vertebral compression fractures

目的探讨经皮椎体成形术(PVP)联合椎旁神经阻滞对老年骨质疏松椎体压缩性骨折患者疼痛、关节功能的影响。方法将72例老年骨质疏松椎体压缩性骨折患者根据治疗方法均分为2组,对照组采用PVP治疗,观察组采用PVP联合椎旁神经阻滞治疗。采用视觉模拟评分法(VAS)评估2组患者术前与术后1周、1个月、3个月、6个月时在静息及活动状态下的疼痛程度,采用Oswestry功能障碍指数(ODI)量表评估2组患者术前与术后1周、1个月、3个月、6个月时的关节功能。结果 2组患者术前静息及活动状态下的VAS评分比较,差异无统计学意义(P> 0. 05);术后1周、1个月、3个月、6个月时,2组患者静息及活动状态下的VAS评分均显著低于术前(P <0. 05),且观察组VAS评分均显著低于对照组(P <0. 05);术前,2组患者ODI评分比较,差异无统计学意义(P> 0. 05);术后1周、1个月、3个月、6个月时,2组患者ODI评分均显著低于术前(P <0. 05),且观察组ODI评分均显著低于对照组(P <0. 05)。结论 PVP联合椎旁神经阻滞可明显减轻老年骨质疏松椎体压缩性骨折患者的疼痛严重程度,还可显著改善患者的关节功能。

Objective To observe the effects of percutaneous vertebroplasty(PVP)combined with paravertebral nerve block on pain and joint function in elderly patients with osteoporotic vertebral compression fractures.Methods A total of 72 elderly patients with osteoporotic vertebral compression fracture were divided into two groups according to treatment methods.The control group was treated with PVP,and the observation group was treated with PVP combined with paravertebral nerve block.The pain degree of two groups in resting and active conditions before operation,at 1 week,1 month 3 months and 6 months afteRoperation was evaluated by Visual Analogue Scale(VAS),and the joint function of two groups at the same time points was evaluated by Oswestry Disability Index(ODI)Scale.Results There were no significant differences in the VAS scores in preoperative resting and active conditions between two groups(P>0.05).The VAS scores of two groups at 1 week,1 month 3 months6 months afteRoperation in resting and active conditions were significantly loweRthan those of preoperation(P<0.05),and the observation group was significantly loweRthan the control group(P<0.05).There was no significant difference in preoperative[JP2]ODI scores between the two groups(P>0.05).The ODI scores of the two groups at 1 week,1 month3 months and 6 months after surgery were significantly loweRthan those of preoperation(P<0.05),and the ODI scores at 1 week,1 month3 months and 6 months afteRsurgery in the observation group were significantly loweRthan that of the control group(P<0.05).Conclusion The treatment of PVP combined with paravertebral nerve block can significantly relieve the pain severity of elderly patients with osteoporotic vertebral compression fracture and significantly improve joint function.