脊神经后支阻滞联合椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的前瞻性对照研究

doi:10.3969/j.issn.1009-976X.2023.02.008

岭南现代临床外科 ›› 2023, Vol. 23 ›› Issue (02): 145-151.DOI: 10.3969/j.issn.1009-976X.2023.02.008

脊神经后支阻滞联合椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的前瞻性对照研究

李钿^1,2, 陈太秋², 洪全², 林加阳², 林可新², 林本丹^1,*

1.汕头大学医学院, 广东汕头515041;
2.揭阳市人民医院骨科, 广东揭阳522081

通讯作者: *林本丹,Email：zxyylbd@sina.com,汕头大学医学院

A prospective control study on the block of posterior branch of spinal nerve combined with percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures

LI Tian^1,2, CHEN Tai-qiu², HONG Quan², LIN Jia-yang², LIN Ke-xin², LIN Ben-dan¹

1. Department of Orthopaedics, Shantou University Medical College, Shantou, Guangdong 515041, China;
2. Department of Orthopaedics, Jieyang People's Hospital, Jieyang, Guangdong 522081, China

Received:2023-02-05 Online:2023-04-20 Published:2023-05-22
Contact: LIN Ben-dan, zxyylbd@sina.com

摘要/Abstract

摘要： 目的探索经皮穿刺球囊扩张椎体后凸成形术（PKP）及与脊神经后支阻滞联合使用对骨质疏松性椎体压缩性骨折（OVCF）的治疗效果,为此类骨折提供更安全且有效的治疗方案。方法本研究分析2021年10月至2022年10月期间于广东省揭阳市人民医院骨科就诊的103例诊断为OVCF的患者,采用随机数表法将其分为PKP组和PKP联合脊神经后支阻滞组（即PKP+阻滞组）,比较两组之间基线资料（年龄、性别、骨密度、手术节段）,比较术前、术后1天、术后7天及术后3个月的临床功能量表评估（VAS评分、ODI评分、MBI评分）等指标。结果与PKP组相比较,PKP+阻滞组术前的资料（年龄、骨密度、VAS评分、ODI评分、MBI评分）等指标无统计学差异（P> 0.05）;术后第1天评估中,PKP+阻滞组的临床量表评估（VAS评分、ODI评分、MBI评分）均优于PKP组（P< 0.05）;术后第7天评估中,PKP+阻滞组的临床量表评估（VAS评分、ODI评分）优于PKP组（P< 0.05）;术后3个月评估中,PKP+阻滞组的临床量表评估（VAS评分、ODI评分、MBI评分）也均优于PKP组（P< 0.05）。结论针对OVCF患者的治疗,不论是短期还是长期的效果,PKP+阻滞组均优于PKP组,提示脊神经后支阻滞联合经皮穿刺球囊扩张椎体后凸成形术是治疗OVCF安全且更为有效的治疗方案。

关键词: 骨质疏松性椎体压缩性骨折, 骨质疏松症, 脊神经后支阻滞, 经皮穿刺球囊扩张椎体后凸成形术

Abstract: Objective To explore the therapeutic effect and safety of the combined application of percutaneous kyphoplasty （PKP）and posterior spinal nerve root block on patients with osteoporotic vertebral compression fracture （OVCF）. Methods A total 103 patients diagnosed with OVCF in the Department of Orthopedics of Jieyang People's Hospitalfrom October 2021 to October 2022, were included in this study. The patients were divided randomly into PKP group （n=51） and PKP+block group （n=52）. The baseline data including age, gender, bone mineral density and surgical segments were collected and recorded and the clinical function scale evaluation was measured and compared between two groups, including Oswestry Disability Index （ODI）, Barthel scale （MBI） and visual analog scale （VAS） in pre-operation, 1 daypostoperatively （POD1）, 7 days postoperatively （POD7） and 3 months postoperatively. Results There were no significant differences in age, bone mineral density, ODI, MBI and VAS between（all P values > 0.05）. On the POD1, the ODI, MBI and VAS score in PKP+block group weresuperior to that of PKP group （all P values < 0.05）. On the POD7, the VAS and ODI of PKP+block group were better than that of PKP group （P < 0.05）. And the VAS, ODI and MBI of PKP+block group were also better than that of PKP group in the 3 months after operation （all P values < 0.05）. Conclusion This study showed that in the patients with OVCF, surgical procedure of PKP+block was superior to PKP alone in short-term and long-term effects and the safety.

Key words: osteoporotic vertebral compression fracture, osteoporosis, posterior spinal nerve root block, percutaneous kyphoplasty

中图分类号:

R683.2

李钿, 陈太秋, 洪全, 林加阳, 林可新, 林本丹. 脊神经后支阻滞联合椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的前瞻性对照研究[J]. 岭南现代临床外科, 2023, 23(02): 145-151.

LI Tian, CHEN Tai-qiu, HONG Quan, LIN Jia-yang, LIN Ke-xin, LIN Ben-dan. A prospective control study on the block of posterior branch of spinal nerve combined with percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures[J]. Lingnan Modern Clinics In Surgery, 2023, 23(02): 145-151.

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脊神经后支阻滞联合椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的前瞻性对照研究

A prospective control study on the block of posterior branch of spinal nerve combined with percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures

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