| 杜鑫丹,于超,李雪,黄兵,罗格,孙军峰,姚明.CT引导下脊神经根射频治疗胸椎压缩性骨折后神经痛[J].浙江中西医结合杂志,2025,35(8): |
| CT引导下脊神经根射频治疗胸椎压缩性骨折后神经痛 |
| CT guided thoracic spinal nerve root radiofrequency therapy for neuralgia of osteoporotic vertebral compressive fracture |
| 投稿时间：2025-04-14 修订日期：2025-06-03 |
| DOI： |
| 中文关键词: 骨质疏松；压缩性骨折；神经痛 射频消融 CT引导 |
| 英文关键词:Osteoporosis Compression fracture Neuralgia Radiofrequency ablation Computer tomography-Guidance |
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| 中文摘要: |
| 目的 观察CT引导下经皮穿刺脊神经根射频治疗胸椎压缩性骨折后神经痛的临床效果。方法 选择笔者所在医院疼痛科2020年1月至2025年3月间胸椎压缩性骨折经保守治疗3个月或椎体成型术一周后疼痛程度视觉模拟评分（VAS）仍大于5分，且CT检查发现有相应椎间孔被压缩塌陷的患者，签署知情同意书于CT引导下对相应塌陷椎间孔内受压脊神经根进行90℃、180 s标准射频消融。术后第2天及1月、3月、6个月再对疼痛程度评分并与术前评分作对比。结果 24例患者均在CT定位引导下穿刺至相应被压缩的椎间孔，高低频电生理测试均能确认电极位置贴近受挤压的脊神经根，射频消融治疗后患者原疼痛区皮肤感觉减退，疼痛显著缓解。术后第2日患者VAS由术前（6.420.93）分降至（2.130.54）分（t=23.158，P=0.000），无血肿或气胸并发症发生。术后1月、3个月、6个月再次电话或门诊随访，仅4例再次疼痛加重，复查MR发现为新发压缩性骨折所致。结论 CT引导下经皮穿刺受压脊神经根射频消融可安全有效的治疗胸椎压缩性骨折后顽固性神经痛。 |
| 英文摘要: |
| Objective Observation of the clinical effect of CT guided percutaneous puncture of thoracic spinal nerve root radiofrequency therapy for neuropathic pain after thoracic vertebral compression fractures. Methods The visual analogue scale (VAS) score for thoracic vertebral compression fractures in the pain department of the author's hospital between January 2020 and March 2025, after conservative treatment for 3 months or one week after vertebral augmentation surgery, remains greater than 5 points, And for patients with corresponding intervertebral foramen compression collapse detected by CT examination, they signed an informed consent form and underwent 90 ℃, 180 s standard radiofrequency ablation of the compressed spinal nerve roots in the corresponding collapsed intervertebral foramen under CT guidance. Score the pain level on the second day after surgery, as well as at 1, 3, and 6 months, and compare it with the preoperative score. Results All 24 patients were guided by CT positioning to puncture the corresponding compressed intervertebral foramen. High and low frequency electrophysiological tests confirmed that the electrode position was close to the compressed spinal nerve root. After radiofrequency ablation treatment, the skin sensation in the original pain area of the patients decreased and the pain was significantly relieved. On the second day after surgery, the patient's VAS score decreased from (6.420.93) points before surgery to (2.130.54) points（t=23.158，P=0.000）, and there were no complications such as hematoma or pneumothorax. After 1 month, 3 months and 6 months of postoperative follow-up by phone or clinic, only 4 cases experienced worsening pain again. Reexamination of MR revealed that it was caused by newly developed compression fractures. Conclusion CT guided percutaneous puncture and radiofrequency ablation of compressed spinal nerve roots can safely and effectively treat refractory neuropathic pain after thoracic vertebral compression fractures. |
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