Stanford School of Medicine, Physical Medicine and Rehabilitation, Redwood City, California 940663, USA.
Pain Med. 2010 Nov;11(11):1674-7. doi: 10.1111/j.1526-4637.2010.00953.x. Epub 2010 Oct 1.
To determine if thoracic facet joints may be a significant secondary pain generator in patients with compression fractures. Traditionally, pain from vertebral compression fractures has been attributed to vertebral body itself. Compression fractures have been shown to increase thoracic kyphosis and thereby increase the thoracic flexion moment; these changes eventually increase the shear stress on the posterior elements.
We present a small case series of patients with thoracic compression fractures managed with intra-articular facet injections.
Tertiary care academic medical center.
Two patients with thoracic compression fractures.
The subjects received fluoroscopically guided thoracic facet steroid injections for pain management.
Change in verbal analog pain score.
Patients with thoracic compression fractures received significant long-lasting relief after receiving fluoroscopically guided intra-articular injections.
Facet joints may be abnormally stressed due to the increasing thoracic flexion moment in anterior compression fractures, which may serve as a secondary pain generator; intra-articular facet blocks may be an alternative to vertebroplasty.
确定胸关节突关节是否可能成为压缩性骨折患者的重要继发疼痛源。传统上，椎体压缩性骨折引起的疼痛归因于椎体本身。研究表明，压缩性骨折会增加胸椎后凸，从而增加胸椎前屈力矩；这些变化最终会增加后柱的剪切力。
我们介绍了一组接受关节内关节突注射治疗的胸压缩骨折患者的小病例系列。
三级保健学术医疗中心。
两名胸压缩骨折患者。
这些患者接受了 X 线引导下的胸椎关节突内类固醇注射以进行疼痛管理。
口述模拟疼痛评分的变化。
接受 X 线引导下关节内注射的胸压缩骨折患者在接受治疗后获得了显著的长期缓解。
由于前压缩性骨折中胸椎前屈力矩的增加，关节突关节可能会受到异常的压力，这可能成为继发疼痛源；关节内关节突阻滞可能是椎体成形术的替代方法。
