超声引导下脊神经后支阻滞联合运动疗法治疗高龄骨质疏松性胸腰椎压缩性骨折患者的临床效果

Clinical effect of ultrasound-guided spinal nerve posterior branch block combined with exercise therapy in the treatment of elderly patients with osteoporotic vertebral compression fracture

目的探讨超声引导下脊神经后支阻滞联合运动疗法治疗高龄骨质疏松性胸腰椎压缩性骨折(OVCF)患者的临床效果。方法选取2017年1月至2019年6月我科收治的100例高龄OVCF患者作为研究对象,采用随机数字表法将其分为对照组与研究组,各50例。对照组行传统保守治疗,研究组在对照组基础上行超声引导下脊神经后支阻滞联合运动疗法。比较两组的疼痛程度、腰椎功能障碍情况、临床疗效、下地时间及并发症发生情况。结果治疗前及治疗后6个月,两组的VAS、ODI评分比较,差异无统计学意义(P>0.05);治疗后1周及1、3个月,研究组的VAS、ODI评分低于对照组,差异具有统计学意义(P<0.05)。研究组的治疗优良率、总有效率分别为82.00%、96.00%,高于对照组的50.00%、82.00%,差异具有统计学意义(P<0.05)。研究组的下地时间短于对照组,并发症总发生率低于对照组(P<0.05)。结论超声引导下脊神经后支阻滞联合运动疗法治疗高龄OVCF患者效果显著,可有效缓解疼痛,改善腰椎功能障碍,降低并发症发生率。

Objective To investigate the clinical effect of ultrasound-guided spinal nerve posterior branch block combined with exercise therapy in the treatment of elderly patients with osteoporotic vertebral compression fracture(OVCF).Methods A total of 100 elderly patients with OVCF admitted in our department from January 2017 to June 2019 were selected as the research objects,and the patients were divided into control group and study group by random number table method,with 50 cases in each group.The control group received traditional conservative treatment,while the study group received ultrasound-guided spinal nerve posterior branch block combined with exercise therapy on the basis of the control group.The degree of pain,lumbar dysfunction,clinical efficacy,ambulation time and complications were compared between the two groups.Results Before treatment and at 6 months after treatment,there were no significant differences in VAS and ODI scores between the two groups(P>0.05);at 1 week,1 month and 3 months after treatment,the VAS and ODI scores in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The excellent and good rate and total effective rate of treatment in the study group were 82.00%and 96.00%respectively,which were higher than 50.00%and 82.00%in the control group,and the differences were statistically significant(P<0.05).The ambulation time in the study group was shorter than that in the control group,total incidence of complications was lower than that in the control group(P<0.05).Conclusion The ultrasound-guided spinal nerve posterior branch block combined with exercise therapy in the treatment of elderly patients with OVCF has significant effect,which can effectively relieve pain,improve lumbar dysfunction and reduce the incidence of complications.