椎体强化结合椎旁神经阻滞治疗椎体压缩骨折远处疼痛的效果

目的探讨椎体强化结合局部神经阻滞对椎体压缩骨折患者远处疼痛的治疗效果。方法100例骨质疏松性胸腰椎椎体压缩骨折伴远处疼痛患者,根据治疗方法的不同分为观察组和对照组,每组各50例。对照组采用经皮椎体成形术(PVP)治疗,观察组采用PVP联合神经阻滞治疗,采用视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)、日常生活能力法(ADL)及SF-12量表评估两组的疗效。结果术后1周、1个月、3个月、6个月时,两组患者在静息及活动状态下的VAS评分均明显低于术前,且观察组患者静息及活动状态下的VAS评分均明显低于对照组,差异均有统计学意义(P均<0.05);两组的ODI评分均明显低于术前,且观察组的ODI评分均明显低于对照组,差异均有统计学意义(P均<0.05);两组患者静息及活动状态下ADL评分均明显低于术前,且观察组患者静息及活动状态下ADL评分均明显低于对照组,差异均有统计学意义(P均<0.05)。术后两组患者SF-12量表中躯体功能、躯体角色、疼痛、健康状况、活力、社会功能、情绪和心理卫生8个维度的评分均明显低于术前,且观察组的SF-12量表评分均明显低于对照组,差异均有统计学意义(P均<0.05)。结论椎体强化联合局部神经阻滞对椎体压缩骨折患者远处疼痛治疗确切有效。

Objective To explore the therapeutic effect of vertebral augmentation combined with local nerve block in the treatment of patients with vertebral compression fracture and distant pain.Methods 100 patients with osteoporotic thoracolumbar vertebral compression fracture with distant pain were divided into observation group and control group according to different treatment methods,with 50 cases in each group.The control group was treated with percutaneous vertebroplasty(PVP)and the observation group was treated with PVP combined with nerve block.The curative effects of the two groups were evaluated by visual analogue scale(VAS),Oswestry dysfunction index(ODI),activity of daily living(ADL)and SF-12 scale.Results At 1 week,1 month,3 months and 6 months after operation,the VAS scores of the two groups were significantly lower than those before operation,and the VAS scores in the resting and active states of the observation group were significantly lower than those of the control group,with statistical significance(all P<0.05);the ODI scores of the two groups were significantly lower than those before operation,and the ODI scores of the observation group were significantly lower than those of the control group,with statistical significance(all P<0.05);in a state of rest and activity,ADL scores of the two groups were significantly lower than those before operation,and the ADL scores of the observation group were significantly lower than those of the control group,with statistical significance(all P<0.05).The scores of physical function,physical role,pain,health status,vitality,social function,emotion and mental health in the two groups after operation were significantly lower than those before operation,and the scores of SF-12 in the observation group were significantly lower than those in the control group,with statistical significance(all P<0.05).Conclusion Vertebral augmentation combined with local nerve block is effective in the treatment of distant pain in patients with vertebral compression fracture.