Clinical Effect of Percutaneous Endoscopic Intercostal Neurectomy in the Treatment of Intercostal Neuralgia after Percutaneous Vertebroplasty for Osteoporotic Thoracic Vertebral Compression Fractures

doi:10.12114/j.issn.1007-9572.2018.00.304

Abstract

Abstract: Background　The elderly usually suffer from Intercostal neuralgia after percutaneous vertebroplasty for osteoporotic thoracic vertebral compression fractures. There are a variety of treatments，while long treatment period and uncertain effect were the main shortages. Therefore，it is important to discuss a safe and effective treatment method with small trauma and quick recovery. Objective　To discuss the effect of percutaneous endoscopic intercostal neurectomy in the treatment of intercostal neuralgia secondary to percutaneous vertebroplasty for osteoporotic thoracic vertebral compression fractures.Methods　We recruited 6 cases of intercostal neuralgia after percutaneous vertebroplasty for osteoporotic thoracic vertebral compression fractures who were treated with percutaneous endoscopic intercostal neurectomy from Hebei General Hospital from August 2014 to December 2017.We collected the data concerning complications such as nerve injury and local hematoma，and Visual Analogue Scale（VAS）score on the 1st day，at the end of the 1st and 3rd months after treatment.Results　Only 1 case had burning sensation of skin along the intercostal nerve after treatment，but disappeared without special management.The intercostal neuralgia in all cases relieved after treatment.The average VAS score on the 1st day，at the end of the 1st and 3rd months after treatment were 1，0，0，respectively.All the cases were followed up for a mean period of 9 months，during which no recurrence was noticed.Conclusion　Percutaneous endoscopic intercostal neurectomy characterized by small trauma，quick recovery，and short treatment period，is safe and effective for intercostal neuralgia after percutaneous vertebroplasty for osteoporotic thoracic vertebral compression fractures，which achieves high patient satisfaction.

Key words: Osteoporotic fracture, Percutaneous endoscopic, Intercostal nerves

摘要： 背景　胸椎骨质疏松性骨折后肋间神经痛常发生于老年人，其临床治疗手段多样，但周期长，效果不确定。为此研究一种创伤小、恢复快、安全、有效的治疗方法显得尤为重要。目的　探讨脊柱内镜下肋间神经切断术治疗胸椎骨质疏松性骨折后肋间神经痛的临床效果。方法　选取2014年8月—2017年12月河北省人民医院骨科行脊柱内镜下肋间神经切断术治疗的胸椎骨质疏松性骨折后肋间神经痛患者6例，记录神经损伤以及局部血肿等并发症发生情况；记录术后第1天及1、3个月后的视觉模拟评分（VAS）。结果　1例患者术后肋间神经分布区出现皮肤烧灼感，后自行消失；6例患者术后肋间神经痛均缓解。术后第1天平均VAS为1分；术后1个月及3个月VAS为0分。平均随访时间为9个月，随访期间肋间神经痛缓解且无复发。结论　脊柱内镜下肋间神经切断术治疗胸椎骨质疏松性骨折后肋间神经痛，具有创伤小、恢复快及治疗周期短等优点，临床效果满意，为一种安全、有效的治疗方法。

关键词: 骨质疏松性骨折, 脊柱内镜, 肋间神经痛

WEI Jingchao,GAO Shangju,XING Dong, et al. Clinical Effect of Percutaneous Endoscopic Intercostal Neurectomy in the Treatment of Intercostal Neuralgia after Percutaneous Vertebroplasty for Osteoporotic Thoracic Vertebral Compression Fractures　[J]. Chinese General Practice, 2019, 22(11): 1319-1322. DOI: 10.12114/j.issn.1007-9572.2018.00.304.
魏景超,高尚聚,邢栋等. 脊柱内镜下肋间神经切断术治疗胸椎骨质疏松性骨折后肋间神经痛的临床效果研究[J]. 中国全科医学, 2019, 22(11): 1319-1322. DOI: 10.12114/j.issn.1007-9572.2018.00.304.

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