Zhang Xin, Li Zong-Xi, Yin Li-Jun, Chen Hui
Department of Anesthesiology and Perioperative Medicine, Shanghai The Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai 200434, China.
Department of Anesthesiology, Ningbo Women and Children's Hospital, Ningbo 315012, China.
World J Clin Cases. 2022 Jul 26;10(21):7523-7530. doi: 10.12998/wjcc.v10.i21.7523.
Neuralgia is frequently noted in patients with Kummell's disease, and its mechanism is complex, rendering it challenging to treat. Percutaneous kyphoplasty (PKP) has been widely used to treat osteoporotic vertebral compression fractures with satisfactory outcomes. However, it is not optimal for managing severely collapsed vertebrae, as cement injection may not be feasible. This report describes the use of a selective nerve block for the treatment of neuralgia caused by severely collapsed vertebrae in a patient with Kummell's disease.
In our patient, three vertebrae were involved. The collapse of T11 was particularly severe. After managing T8 and T9 using PKP, these two segments were effectively strengthened; consequently, back pain was significantly relieved. However, the structure and strength of T11 could not be effectively restored using a minimally invasive surgical method because there was little room for cement injection. This caused obvious neuralgia according to the postoperative status of the PKP. Thus, we performed selective nerve blocks for the treatment of neuralgia, which resulted in satisfactory outcomes.
Selective nerve block may be a possible therapeutic strategy for neuralgia due to severely collapsed vertebrae in Kummell's disease.
Kummell病患者常伴有神经痛，其机制复杂，治疗颇具挑战性。经皮椎体后凸成形术（PKP）已广泛用于治疗骨质疏松性椎体压缩骨折，效果良好。然而，对于严重塌陷的椎体，PKP并非最佳选择，因为骨水泥注射可能不可行。本报告介绍了在1例Kummell病患者中使用选择性神经阻滞治疗严重塌陷椎体所致神经痛的情况。
我们的患者累及3个椎体。T11椎体塌陷尤为严重。采用PKP处理T8和T9椎体后，这两个节段得到有效强化，背痛明显缓解。然而，由于骨水泥注射空间狭小，无法通过微创手术有效恢复T11椎体的结构和强度。根据PKP术后情况，这导致了明显的神经痛。因此，我们采用选择性神经阻滞治疗神经痛，效果满意。
选择性神经阻滞可能是治疗Kummell病严重塌陷椎体所致神经痛的一种可行治疗策略。
