胸腰段椎体压缩骨折后远隔部位疼痛的诊治

目的 探讨胸腰段椎体压缩骨折后的远隔部位疼痛的原因及解决方法.方法 回顾分析14例伴有远隔部位疼痛的胸腰段椎体压缩骨折的病例,观察疼痛出现的部位,与胸腰段压缩骨折的关系及治疗方法.结果 14例伴有腰骶疼痛的胸腰段椎体压缩骨折的病例,疼痛部位位于第4、5腰椎有椎旁肌(6例)、髂脊上下(5例)以及季肋下(3例),有5例在骨折灌注骨水泥后疼痛消失,7例经局部封闭注射后疼痛消失,2例口服止痛药物缓解.结论 胸腰段椎体压缩骨折后的远隔部位疼痛的原因可能是骨折部位的神经根刺激产生的放射痛,或者是远隔部位的软组织损伤疼痛,对疼痛及时治疗可有效缓解患者的症状.

Distant pain after thoracolumbar compressive fracture

Objective To retrospectively analyze the causes and treatment of distant pain after thoracolumbar compressive fracture. Methods The investigators retrospectively analyzed 14 cases of thoracolumbar compressive fracture with distant pain,observed the pain region and its relationship with thoracolumbar compressive fracture and administered the treatment of pain. Results There were 14 cases of thoracolumbar compressive fracture with lumbarsacral pain whose painful region were located in paravertebral muscles (n=6),near iliac crest (n=5) and in hypochondrium (n=3). Five and 7 cases of pain disappeared after vertebroplasty and local injection respectively and 2 cases were relieved with analgesics.Eighteen patients with throcolumbar vertebrae fractures (T11-L2) were fixed with short segment pedical screw fixation,the instrumentation removed at 1 year post-operation and their Cobb's angle and trauma vertebra height measured from 0. 5-2 years after instrumentation removal. Conclusion The cause of distant pain after thoracolumbar compressive fracture maybe be related with radiating pain resulting from irritated nerves in the vertebral fracture region or distant soft tissue pain. A timely pain treatment can relieve the patients' symptoms.