摘要：

目的 探讨腰神经后支脉冲射频术联合神经阻滞术治疗老年腰椎骨质疏松性椎体压缩骨折疼痛的有效性。方法 共 76 例老年腰椎骨质疏松性椎体压缩骨折疼痛患者，分别采用腰神经后支阻滞术（37 例）和腰神经后支脉冲射频术联合神经阻滞术（39 例），采用视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）和 12 条简明健康状况调查表（SF-12）评价手术疗效。结果 与治疗前相比，腰神经后支阻滞术组和腰神经后支脉冲射频术联合神经阻滞术组患者治疗后 VAS 和 ODI 评分降低（均 P = 0.000），SF-12 量表 8 个维度（躯体功能、躯体角色、疼痛、健康状况、活力、社会功能、情绪、心理卫生）评分和总评分升高（均 P = 0.000）；与腰神经后支阻滞术组相比，腰神经后支脉冲射频术联合神经阻滞术组患者治疗后 VAS 和 ODI 评分降低（P = 0.044，0.027），SF-12 量表 8 个维度（躯体功能、躯体角色、疼痛、健康状况、活力、社会功能、情绪、心理卫生）评分和总评分升高（P = 0.032，0.037，0.028，0.024，0.035，0.047，0.038，0.026，0.029）。结论 与腰神经后支阻滞术相比，腰神经后支脉冲射频术联合神经阻滞术治疗老年腰椎骨质疏松性椎体压缩骨折疼痛的临床疗效更显著，值得临床推广应用。

关键词: 骨折, 压缩性, 骨质疏松, 腰椎, 疼痛, 脊神经, 脉冲射频（非 MeSH 词）, 神经传导阻滞

Abstract:

Objective To explore the clinical effect of pulse radiofrequency via posterior branch of lumbar nerve combined with nerve block in the treatment of senile lumbar osteoporotic compression fracture pain. Methods A total of 76 patients with senile lumbar osteoporotic compression fracture pain were reported. Thirty-nine cases underwent pulse radiofrequency via posterior branch of lumbar nerve combined with nerve block (combination group), and 37 cases only underwent nerve block via posterior branch of lumbar nerve (control group). Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) were used to evaluate clinical efficacy. Results  Compared with before treatment, VAS and ODI scores were significantly decreased (P = 0.000, 0.000), 8 dimension scores (physical function, physical role, pain, health status, vitality, social function, mood and mental health) and total score of SF-12 were significantly increased (P = 0.000, for all) after treatment in both groups. Compared with control group, VAS and ODI scores were significantly decreased (P = 0.044, 0.027), 8 dimension scores (physical function, physical role, pain, health status, vitality, social function, mood and mental health) and total score of SF-12 were significantly increased (P = 0.032, 0.037, 0.028, 0.024, 0.035, 0.047, 0.038, 0.026, 0.029) in combination group. Conclusions Compared with nerve block, the clinical effect of pulse radiofrequency via posterior branch of lumbar nerve combined with nerve block is more prominent in the treatment of senile lumbar osteoporotic compression fracture pain, so it should be used in clinical practice.

Key words: Fractures, compression, Osteoporosis, Lumbar vertebrae, Pain, Spinal nerves, Pulse radiofrequency (not in MeSH), Nerve block