椎体成形术后残留腰背痛与腰背筋膜损伤的相关性研究

背景:椎体成形术可有效缓解骨质疏松性椎体压缩骨折引起的疼痛,但是部分患者术后短期内仍残留轻度至中度疼痛。而这种残留的腰背痛可能与腰背筋膜损伤相关。目的:探讨骨质疏松性椎体压缩骨折行椎体成形术后腰背痛缓解和腰背筋膜损伤的关系。方法:2010年2月至2012年3月收治骨质疏松性椎体压缩骨折患者133例,行椎体成形术治疗,术前通过MR检查确定责任椎,并观察腰背筋膜损伤情况。术前术后通过视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评估患者的疼痛程度。结果:腰背筋膜损伤组患者VAS、ODI术前为9.11±0.76、73.93%±1.46%,术后为2.70±0.83、29.34%±2.69%;无腰背筋膜损伤组患者VAS、ODI术前为9.26±0.82、73.96%±1.38%,术后为1.23±0.87、22.27%±1.25%。腰背筋膜损伤组患者术后残留的疼痛较无腰背筋膜损伤组患者更为严重;两者的差异具有统计学意义。结论:骨质疏松性椎体压缩骨折患者行椎体成形术后残留腰背部疼痛与腰背筋膜损伤具有相关性。

Correlation between pain relief after percutaneous vertebroplasty and lumbar fascia injury

Background： Percutaneous vertebroplasty is an effective measure to relieve pain caused by osteoporotic vertebral compression fractures （OVCFs）, but some patients still feel mild to moderate pain after percutaneous vertebroplasty. It is speculated that there is correlation between remained lumbodorsal pain and lumbar fascia injury. Objective： The purpose of the study is to explore the correlation between pain relief after percutaneous vertebroplasty and lumbar fascia injury. Methods： From February 2010 to March 2012, 133 elderly patients with OVCFs were treated with percutaneous vertebroplasty in our hospital. The painful vertebra and the injured lumbar fascia were determined by the signal intensity changes in MR images before operation.The visual analog scale （VAS） and the Oswestry Disability Index （ODI） were used to evaluate the pain before and after surgery. Results： The VAS and ODI of the patients with lumbar fascia injury were 9.11±0.76 and 73.93%±1.46% before vertebroplasty. They were 2.70±0.83 and 29.34%±2.69%, respectively, after vertebroplasty. In the patients without lumbar fascia injury, the VAS and ODI were 9.26±0.82 and 73.96%±1.38% before vertebroplasty, and 1.23±0.87 and 22.27%±1.25% after vertebroplasty. Pain relief in the patients without lumbar fascia injury was significantly better than the patients with lumbar fascia injury. Conclusions： Pain relief may be correlated with lumbar fascia injury after percutaneous vertebroplasty.