Park Ki Deok, Jee Haemi, Nam Hee Seung, Cho Soo Kyoung, Kim Hyoung Seop, Park Yongbum, Lim Oh Kyung
Deaprement of Rehabilitation Medicine, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.
Ann Rehabil Med. 2013 Apr;37(2):191-201. doi: 10.5535/arm.2013.37.2.191. Epub 2013 Apr 30.
To evaluate the outcomes of medial branch block in facet joint pain for osteoporotic compression fracture and utilize multiple regression, the relationship between their impact on treatment outcome and other factor, such as the radiologic finding, clinical parameters was analyze.
Fifty-three patients with axial back pain from osteoporotic compression fracture were enrolled. The clinical outcomes were measured by Verbal Numeric Rating Scale (VNS) and Oswestry Disability Index (ODI) before treatment, 2 weeks, 3 months, and 12 months after the medial branch block. Radiographic analysis included measurement of overall sagittal alignment, collapsed vertebral height, and vertebral kyphotic angle. After 12 months, patients' satisfaction was classified to five categories: excellent, good, fair, poor or fail. Statistical analysis of both radiographic and clinical parameters along with treatment outcome was performed to determine any significant correlations between the two.
VNS and ODI was improved 2 weeks after the injection and continued to improve until 12 months. Significant improvement with significant pain relief (>40%), functional improvement (>20%), and the patients rated their satisfaction level as "excellent" or "good" at 12 months after the first injection were observed in 78.9%. The radiographic and clinical parameters were not significantly correlated with treatment outcome.
Our retrospective study demonstrated that the medial branch block provided significant pain relief and functional recovery to the patients with osteoporotic spinal compression fractures complaining of continuous facet joint pain after vertebroplasty or conservative treatment. A placebo-controlled prospective randomized double-blind study should be conducted in the future to evaluate the treatment effects.
评估内侧支阻滞治疗骨质疏松性压缩骨折小关节疼痛的疗效，并利用多元回归分析其对治疗结果的影响与其他因素（如影像学表现、临床参数）之间的关系。
纳入53例因骨质疏松性压缩骨折导致轴向背痛的患者。在进行内侧支阻滞治疗前、治疗后2周、3个月和12个月，采用视觉数字评分量表（VNS）和Oswestry功能障碍指数（ODI）测量临床疗效。影像学分析包括测量整体矢状位对线、椎体塌陷高度和椎体后凸角。12个月后，将患者的满意度分为优秀、良好、中等、差或失败五类。对影像学和临床参数以及治疗结果进行统计分析，以确定两者之间是否存在显著相关性。
注射后2周VNS和ODI有所改善，并持续改善至12个月。78.9%的患者在首次注射后12个月出现显著疼痛缓解（>40%）、功能改善（>20%），且患者将其满意度评为“优秀”或“良好”。影像学和临床参数与治疗结果无显著相关性。
我们的回顾性研究表明，内侧支阻滞为经椎体成形术或保守治疗后仍抱怨小关节持续疼痛的骨质疏松性脊柱压缩骨折患者提供了显著的疼痛缓解和功能恢复。未来应进行安慰剂对照的前瞻性随机双盲研究以评估治疗效果。
