神经根封闭治疗骨质疏松性椎体骨折所致疼痛的效果研究
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摘要
目的:研究分析神经根封闭治疗骨质疏松性椎体骨折所致疼痛的效果。方法:选取2016年5月-2017年8月医院收治的骨质疏松性椎体骨折所致疼痛患者40例展开探究,于C形臂X线机透视下取穿刺针穿刺至受累神经根的椎间孔中心,注射布比卡因、利多卡因及甲基泼尼松龙混合液,完成神经根封闭治疗,比较治疗前后患者疼痛情况及治疗后的总体效果。结果:40例患者中注射2次有31例(77.50%),注射3次有9例(22.50%),未出现相关并发症。平均随访8～13个月,患者疗效为优有8例(20.00%),良25例(62.50%),可7例(17.50%),优良率为82.50%(33/40);治疗前的视觉模拟评分法(VAS)评分为(7.82±1.63)分,治疗后的VAS评分为(3.27±1.06)分,治疗后VAS评分显著低于治疗前评分(P <0.05)。结论:临床治疗骨质疏松性椎体骨折所致疼痛采用神经根封闭治疗效果确切,能够有效缓解患者疼痛,且具有较高的安全性,对于保守治疗无效或经皮椎体成形术前可先予以神经根封闭治疗,值得推广。
Objective: To study the effect of nerve root closure in the treatment of pain caused by osteoporotic vertebral fracture. Methods: 40 patients with pain caused by osteoporotic vertebral fracture admitted to the hospital from May 2016 to August 2017 were selected for study. the intervertebral foramen center of the involved nerve roots was taken under c-arm X-ray machine fluoroscopy, and the mixture of bupivacaine, lidocaine and methylprednisolone was injected to complete the nerve root sealing treatment, and the pain condition of the patients before and after the treatment was compared with the overall effect after the treatment. Results: Among the 40 patients, 31(77.50%) were injected 2 times and 9(22.50%) were injected 3 times, without related complications. Patients were followed up for 8 to 13 months on average, with 8 excellent cases(20.00%), 25 good cases(62.50%), 7 effective cases(17.50%), and the excellent rate was 82.50%(33/40). Visual analogue scale(VAS) score before treatment was(7.82±1.63) points, VAS score after treatment was(3.27±1.06) points, VaS score after treatment was significantly lower than that before treatment(P < 0.05). Conclusion: In the clinical treatment of pain caused by osteoporotic vertebral fracture, nerve root sealing treatment was effective in relieving pain of patients and had high safety. It was worthy of promotion to apply nerve root sealing treatment before conservative treatment or percutaneous vertebroplasty.
Objective: To study the effect of nerve root closure in the treatment of pain caused by osteoporotic vertebral fracture. Methods: 40 patients with pain caused by osteoporotic vertebral fracture admitted to the hospital from May 2016 to August 2017 were selected for study. the intervertebral foramen center of the involved nerve roots was taken under c-arm X-ray machine fluoroscopy, and the mixture of bupivacaine, lidocaine and methylprednisolone was injected to complete the nerve root sealing treatment, and the pain condition of the patients before and after the treatment was compared with the overall effect after the treatment. Results: Among the 40 patients, 31(77.50%) were injected 2 times and 9(22.50%) were injected 3 times, without related complications. Patients were followed up for 8 to 13 months on average, with 8 excellent cases(20.00%), 25 good cases(62.50%), 7 effective cases(17.50%), and the excellent rate was 82.50%(33/40). Visual analogue scale(VAS) score before treatment was(7.82±1.63) points, VAS score after treatment was(3.27±1.06) points, VaS score after treatment was significantly lower than that before treatment(P < 0.05). Conclusion: In the clinical treatment of pain caused by osteoporotic vertebral fracture, nerve root sealing treatment was effective in relieving pain of patients and had high safety. It was worthy of promotion to apply nerve root sealing treatment before conservative treatment or percutaneous vertebroplasty.
引文
[1]黄洪斌,季向荣,林忠凯,等.脊神经后侧支脉冲射频治疗骨质疏松性椎体骨折疼痛疗效观察[J].浙江医学,2017,39(05):380-381,388.
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[8]王振东,关智媛,关永林,等.补肾活血汤治疗老年骨质疏松性椎体骨折PKP术后临床观察[J].实用中西医结合临床,2017,17(07):116-118.
[9]刘保良.单侧与双侧入路行椎体成形术治疗老年骨质疏松性椎体骨折[J].实用中西医结合临床,2017,17(12):24-26.
[10]张功林,甄平,陈克明,等.神经根封闭治疗骨质疏松性椎体骨折疼痛[J].国际骨科学杂志,2013,34(05):381-382.
[2]温晓阳,余凯龙,何东生,等.经皮椎体成形术治疗症状性陈旧性骨质疏松性椎体骨折[J].生物骨科材料与临床研究,2017,14(04):71-72,74.
[3]郭龙,于凤宾,陶德刚,等.保守治疗和椎体后凸成形术治疗骨质疏松性椎体骨折的疗效比较[J].浙江临床医学,2017,19(08):1397-1398,1401.
[4]龚景海,顾国明,王小军,等.经皮椎体成型术治疗老年骨质疏松性椎体骨折32例[J].淮海医药,2015,22(06):546-547.
[5]徐贞官,黄永光,黄国勤,等.腰神经根封闭术在多节段退行性腰椎疾病中的应用价值[J].中国现代医药杂志,2016,18(08):39-41.
[6]冯献礼,赵景才,高彤,等.手法复位联合PKP治疗老年骨质疏松性椎体骨折效果分析[J].山东医药,2016,56(14):93-94.
[7]杨惠林,刘昊,殷国勇,等.我国经皮椎体后凸成形术治疗骨质疏松性椎体骨折现状与创新[J].中华骨质疏松和骨矿盐疾病杂志,2017,10(01):12-19.
[8]王振东,关智媛,关永林,等.补肾活血汤治疗老年骨质疏松性椎体骨折PKP术后临床观察[J].实用中西医结合临床,2017,17(07):116-118.
[9]刘保良.单侧与双侧入路行椎体成形术治疗老年骨质疏松性椎体骨折[J].实用中西医结合临床,2017,17(12):24-26.
[10]张功林,甄平,陈克明,等.神经根封闭治疗骨质疏松性椎体骨折疼痛[J].国际骨科学杂志,2013,34(05):381-382.