摘要
目的探讨CT引导下椎体成形联合脊神经背根节脉冲射频消融术治疗骨质疏松性椎体骨折的临床效果。方法选取我院2021年10月至2025年2月收治的骨质疏松性椎体骨折患者89例,根据手术方式分为对照组(43例,采用CT引导下椎体成形术治疗)和观察组(46例,采用CT引导下椎体成形联合脊神经背根节脉冲射频消融术)。于治疗前及治疗后1周、3周、7周,采用数字评分法(NRS)评价患者疼痛程度,采用匹兹堡睡眠质量指数(PSQI)评价患者睡眠质量,采用Oswestry功能障碍指数(ODI)评估患者椎体功能,采用Cobb角及伤椎前缘高度比评价患者椎体恢复情况;记录患者局部感染、头晕、血肿等不良反应发生情况。结果2组患者NRS评分、PSQI评分、ODI、Cobb角、伤椎前缘高度比在组间、时间、交互方面差异显著(P<0.05)。观察组患者治疗后各时间点的NRS评分、Cobb角均低于对照组(P<0.05)。观察组患者治疗后3周、7周的ODI、PSQI评分均低于对照组(P<0.05),伤椎前缘高度比均高于对照组(P<0.05)。2组患者治疗后NRS评分、PSQI评分、ODI、Cobb角均低于治疗前(P<0.05),伤椎前缘高度比均高于治疗前(P<0.05)。2组患者不良反应总发生率比较,差异无显著统计学意义(P>0.05)。结论CT引导下椎体成形联合脊神经背根节脉冲射频消融术可有效缓解骨质疏松性椎体骨折患者疼痛,从而改善患者睡眠质量,促进椎体恢复,安全性较高。
Objective To investigate the clinical effect of CT-guided vertebroplasty combined with pulsed radiofrequency ablation of the dorsal root ganglion in the treatment of osteoporotic vertebral fractures.Methods A total of 89 patients with osteoporotic vertebral fractures admitted to our hospital from October 2021 to February 2025 were selected and divided into the control group(43 patients were treated with CT-guided vertebroplasty)and the observation group(46 patients were treated with CT-guided vertebroplasty combined with pulsed radiofrequency ablation of the dorsal root ganglion)according to surgical methods.Before treatment and 1 week,3 weeks and 7 weeks after treatment,the patients´pain degree was evaluated by numerical rating scale(NRS),the patients´sleep quality was evaluated by Pittsburgh sleep quality index(PSQI),the patients´vertebral function was evaluated by Oswestry disability index(ODI),and the patients´vertebral recovery was evaluated by Cobb angle and anterior vertebral body height ratio.The occurrence of adverse reactions such as local infection,dizziness,hematoma of patients were recorded.Results There were significant differences in the NRS score,PSQI score,ODI,Cobb angle and anterior vertebral body height ratio between the two groups of patients in terms of inter group,time,and interaction(P<0.05).The NRS score and Cobb angle of patients in the observation group were lower than those in the control group at each time points after treatment(P<0.05).The ODI and PSQI scores of patients in the observation group were lower than those in the control group at 3 and 7 weeks after treatment(P<0.05),and the anterior vertebral body height ratio of patients in the observation group was higher than that in the control group(P<0.05).After treatment,the NRS score,PSQI score,ODI and Cobb angle of patients in the two groups were all lower than those before treatment(P<0.05),and the anterior vertebral body height ratio were all higher than those before treatment(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups of patients(P>0.05).Conclusion CT-guided vertebroplasty combined with pulsed radiofrequency ablation of the dorsal root ganglion can effectively relieve the pain of patients with osteoporotic vertebral fractures,and then improve the sleep quality of patients,promote the recovery of vertebral body,with high safety.
作者
黄志强
刘炯峰
赖尚导
HUANG Zhi-qiang;LIU Jiong-feng;LAI Shang-dao(Pain Medicine Department,Meizhou People's Hospital,Meizhou Guangdong 514000,China)
出处
《局解手术学杂志》
2025年第12期1032-1036,共5页
Journal of Regional Anatomy and Operative Surgery
基金
广东省医学科学技术研究基金项目(2023130219916)
梅州市社会发展科技计划项目(2023C0301182)。
