小针刀预防骨质疏松性椎体压缩性骨折椎体成形术后残余痛临床观察

Clinical Observation of Small Needle Knife in Preventing Residual Pain after Vertebroplasty in Osteoporotic Vertebral Compression Fracture

目的:观察小针刀疗法在预防经皮椎体后凸成形术(PKP)后残余痛的临床疗效。方法:选取符合标准的老年骨质疏松压缩性骨折的老年患者60例,依随机法将患者分为2组,每组各30例。对照组给予经皮椎体成形术;治疗组在对照组方案的基础上于术毕观察患者期间寻找腰背部痛点进行小针刀治疗。术前术后通过观察视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)和改良JOA下腰痛评分来评估患者的疼痛及功能。通过随访术后3天,术后1月、术后6月VAS评分、ODI评分、JOA评分分别与治疗前比较;以及治疗组术后3天、术后1月,术后6月VAS评分、ODI评分、JOA评分与对照组比较,来观察小针刀疗法预防PKP术后残余痛的临床疗效。结果:2组术后3天、术后1月、术后6月的VAS评分、ODI评分、JOA评分分别与治疗前比较,差异有统计学意义(P<0.05);术后3天、术后1月治疗组VAS评分、ODI评分、JOA评分均优于对照组,差异有统计学意义(P<0.05),术后6月治疗组与对照组比较,差异无统计学意义(P>0.05)。结论:小针刀治疗能减轻椎体成形术后早期的腰背部残余痛,可巩固提升临床疗效,提高患者满意度,值得推广应用。

Objective:To observe the clinical effect of small needle knife therapy in preventing residual pain after percutaneous kyphoplasty(PKP).Methods:A total of 60 elderly patients with osteoporotic compression fractures meeting the criteria were selected,and the patients were randomly divided into 2 groups with 30 cases in each group.The control group was given percutaneous vertebroplasty;the treatment group was treated with a small needle knife on the basis of the control group’s plan during the observation of patients at the end of the operation.The visual analogue scale(VAS),Oswestry dysfunction index(ODI)and modified JOA low back pain score were observed before and after surgery to assess the patient’s pain and function.The VAS score,ODI score,and JOA score were compared with those before treatment by follow-up for 3 days,1 month and 6 months after the operation,respectively;and the VAS score of the treatment group was 3 days after the operation,1 month after the operation,and 6 months after the operation.The ODI score and JOA score were compared with the control group to observe the clinical efficacy of small needle knife therapy in preventing residual pain after PKP surgery.Results:The VAS scores,ODI scores,and JOA scores of the two groups were compared with those before treatment at 3 days after surgery,1 month after surgery,and 6 months after surgery.The difference was statistically significant(P<0.05);The VAS score,ODI score,and JOA score of the treatment group were better than those of the control group in the next month,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the treatment group and the control group at 6 months after the operation(P>0.05)).Conclusion:The small needle knife treatment can alleviate the early residual pain in the lower back after vertebroplasty,consolidate and improve the clinical efficacy,and improve patient satisfaction.It is worthy of popularization and application.