[1]石鑫超,张国忠,齐峰,等.超声引导下针刀松解脊神经背内侧支治疗椎体成形术后腰背痛36例[J].中国中医骨伤科杂志,2024,32(05):84-87.[doi:10.20085/j.cnki.issn1005-0205.240516]
　SHI Xinchao,ZHANG Guozhong,QI Feng,et al.36 Cases Clinical Study on the Treatment of Low Back Pain after PKP with Acupotomy under Ultrasound Guidance to Relax the Dorsal Medial Branch of the Spinal Nerve[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(05):84-87.[doi:10.20085/j.cnki.issn1005-0205.240516]
点击复制

超声引导下针刀松解脊神经背内侧支治疗椎体成形术后腰背痛36例()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年05期
页码:
84-87
栏目:
临床报道
出版日期:
2024-05-15

文章信息/Info

Title:
36 Cases Clinical Study on the Treatment of Low Back Pain after PKP with Acupotomy under Ultrasound Guidance to Relax the Dorsal Medial Branch of the Spinal Nerve
文章编号:
1005-0205(2024)05-0084-04
作者:
石鑫超1; 张国忠1; 齐峰1; 何鹏宇1; 贾恒霞1; 熊国星1△
1北京中医药大学东直门医院(北京,101100)
Author(s):
SHI Xinchao1; ZHANG Guozhong1; QI Feng1; HE Pengyu1; JIA Hengxia1; XIONG Guoxing1△
1Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 101100,China.
关键词:
超声引导;  针刀;  骨质疏松性椎体压缩性骨折;  经皮穿刺球囊扩张椎体后凸成形术;  腰背痛
Keywords:
ultrasound guidance;  acupotomy;  osteoporotic vertebral compression fracture;  percutaneous balloon kyphoplasty;  low back pain
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.240516
文献标志码:
B
摘要:
目的:观察超声引导下针刀松解脊神经背内侧支治疗经皮穿刺球囊扩张椎体后凸成形术(PKP)后腰背痛的临床疗效。方法:回顾性分析2021年6月至2023年6月椎体后凸成形术后残留腰背部疼痛的骨质疏松性椎体压缩性骨折患者,采用超声引导下针刀松解脊神经背内侧支治疗,每周1次,共治疗3次。记录并分析治疗前、治疗后即刻及治疗后1个月的疼痛视觉模拟量表(VAS)评分及Oswestry功能障碍指数(ODI)评分。结果:患者治疗结束1个月后VAS评分为(1.22±0.79)分,低于治疗前的(4.94±0.91)分及治疗后即刻的(3.42±1.14)分; 治疗结束后1个月ODI评分为(23.33±8.90)分,较治疗前的(58.02±11.54)分与治疗后即刻的(42.35±10.17)分均有明显降低,差异均有统计学意义(P<0.05)。临床治疗总有效率为97.22%。结论:采用超声引导下针刀松解脊神经背内侧支治疗椎体后凸成形术后腰背痛取得满意的临床效果,能减轻患者腰背部疼痛,明显改善腰背部功能障碍,值得进一步推广应用。
Abstract:
Objective:To observe and study the clinical efficacy of acupotomy under ultrasound guidance to release the dorsal medial branches of the spinal nerve in the treatment of low back pain after percutaneous balloon kyphoplasty(PKP).Methods:A retrospective analysis was conducted of patients with residual back pain after PKP surgery from June 2021 to June 2023.They underwent treatment using acupuncture and scalpel guided by ultrasound to relax the dorsal and medial branches of the spinal nerves once per week for a total of 3 treatments.The pain visual analogue scale(VAS)scores and Oswestry disability index(ODI)scores before treatment,after treatment,and 1 month after treatment were recorded and analyzed.Results:The VAS scores of the patient were(1.22±0.79)points after 1 month of treatment,lower than the pre-treatment scores(4.94±0.91)points and the post-treatment scores(3.42±1.14)points.The ODI scores were significantly lower at 1 month after treatment(23.33±8.90)points compared to the pre-treatment scores(58.02±11.54)points and the post-treatment scores(42.35±10.17)points.The differences were statistically significant(P<0.05).The overall clinical efficacy rate was 97.22%.Conclusion:The use of ultrasound-guided acupotomy to release the dorsal medial branch of the spinal nerve in the treatment of low back pain after PKP has achieved satisfactory clinical results.It can relieve low back pain and significantly improve low back dysfunction,and is worthy of further clinical application.

参考文献/References:

[1] 印平,马远征,马迅,等.骨质疏松性椎体压缩性骨折的治疗指南[J].中国骨质疏松杂志,2015,21(6):643-648.
[2] LI Q D,YANG J S,GONG H L,et al.Can additional facet joint block improve the clinical outcome of kyphoplasty for acute osteoporotic vertebral compression fractures?[J].Pain Physician,2021,24(3):283-291.
[3] LI Y,YUE J,HUANG M,et al.Risk factors for postoperative residual back pain after percutaneous kyphoplasty for osteoporotic vertebral compression fractures[J].Eur Spine J,2020,29(10):2568-2575.
[4] 林巧璇,刘晶,卢莉铭,等.补肾活血汤对骨质疏松性椎体压缩性骨折PKP术后患者疼痛和骨代谢的影响[J].中国中医骨伤科杂志,2021,29(3):21-26.
[5] WILSON D J,OWEN S,CORLILL R A.Facet joint injections as a means of reducing the need for vertebroplasty in insufficiency fractures of the spine[J].European Radiology,2011,21(8):1772-1778.
[6] ZHANG Y L,SHI L J,TANG P F,et al.Correlation analysis of osteoporotic vertebral compression fractures and spinal sagittal imbalance[J].Der Orthopade,2017,46(3):249-255.[7] GEORGY B A.Interventional techniques in managingpersistent pain after vertebral augmentation procedures:a retrospective evaluation[J].Pain Physician,2007,10(5):673-676.
[8] KIM D E,KIM H S,KIM S W,et al.Clinical analysis of acute radiculopathy after osteoporotic lumbar compression fracture[J].Journal of Korean Neurosurgical Society,2015,57(1):32-35.
[9] CAVANAUGH J M,OZAKTAY A C,YAMASHITA H T,et al.Lumbar facet pain:biomechanics,neuroanatomy and neurophysiology[J].Journal of Biomechanics,1996,29(9):1117-1129.
[10] ZHANG S,ZHAO Z,WINKELSTEIN B A.A nociceptive role for integrin signaling in pain after mechanical injury to the spinal facet capsular ligament[J].Annals of Biomedical Engineering,2017,45(12):2813-2825.
[11] LI Y,WANG X,JIANG K,et al.Incidence and risk factors of facet joint violation following percutaneous kyphoplasty for osteoporotic vertebral compression fractures[J].Acta Radiol,2019,60(6):755-761.
[12] LI Y,HUANG M Y,CHEN J X,et al.The impact of facet joint violation on clinical outcomes after percutaneous kyphoplasty for osteoporotic vertebral compression fractures[J].World Neurosurg,2018,119:e383-e388.
[13] LAN P,MERCER S,GOVIND J,et al.The surgical anatomy of lumbar medial branch neurotomy(facet denervation)[J].Pain Medicine(Malden,Mass),2004,5(3):289-298.
[14] 任建平.针刀治疗老年骨质疏松性椎体骨折PKP术后疼痛的临床观察[J].世界最新医学信息文摘,2019,19(66):39-40.
[15] 陈祢,沈红,王宝兰.高频超声对传统盲法针刀松解术治疗肩周炎定位及操作准确度的观察研究[J].华西医学,2018,33(10):1262-1266.
[16] 刘巧媚,周丹,徐芸,等.借助超声辅助手段促进针刀治疗可视化发展[J].湖北中医药大学学报,2016,18(4):117-120.
[17] 程传喜,王继霜,周密.超声引导下胸腰筋膜平面阻滞对单节段腰椎骨折术后静脉镇痛的影响[J].临床麻醉学杂志,2019,35(9):854-857.

备注/Memo

备注/Memo:
基金项目:北京市通州区科技计划重点项目(KJ2023CX058)
△通信作者 E-mail:407497326@qq.com
更新日期/Last Update: 2024-05-15