骨质疏松椎体压缩性骨折躯体牵涉痛的临床分型及治疗

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摘要目的分析骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture，OVCF)患者躯体牵涉痛的临床特点及治疗效果。方法回顾性分析2013年6月至2017年6月我科住院治疗的OVCF患者的临床资料，41例存在躯体牵涉痛，其中男8例，女33例；年龄64～91岁，平均(75.5±5.5)岁。根据躯体牵涉痛的部位分为A~E型，所有患者均行经皮椎体后凸成形术治疗，采用视觉模拟评分(visual analogue scale，VAS)及Oswestry功能障碍指数(Oswestry disability index，ODI)评估治疗效果。结果 41例OVCF患者根据躯体牵涉痛部位分型，A型20例，B型7例，C型6例，D型3例，E型5例。所有患者术后及末次随访时VAS评分及ODI评分均较术前有明显改善(P＜0.05)。各分型之间比较术前VAS及ODI评分均无统计学差异(P＞0.05)，术后及末次随访时VAS及ODI评分均存在统计学差异(P＜0.01)。结论躯体牵涉痛在OVCF患者中较为常见，A型是最为常见的类型，D型和E型较为少见。经皮椎体后凸成形术治疗OVCF可有效缓解躯体牵涉痛。

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关键词 ：骨质疏松, 脊柱骨折, 牵涉痛, 椎体成形术

Abstract：Objective To analyze the clinical characteristics and clinical treatment effect of somatic referred pain of osteoporotic vertebral compression fracture(OVCF).Methods The clinical data of patients with OVCF hospitalized in our department from June 2013 to June 2017 were retrospectively analyzed.41 patients with somatic referred pain were enrolled this study.There were 8 males and 33 females，with an average age of (75.5±5.5)(range 64~91).The Type of somatic referred pain were classified into A~E types according to the pain distribution patterns.All patients underwent percutaneous kyphoplasty(PKP) ，the visual analog scale (VAS) and the Oswestry disability index (ODI) were recorded preoperatively and postoperatively to assess the pain and disability degree of patients.Results 41 patients were analyzed and types distribution were 20 cases of Type A，7 cases of Type B，6 cases of Type C，3 cases of Type D and 5 cases of Type E.The VAS and ODI significantly improved postoperatively and final follow-up in all patients(P＜0.05).There was no significant difference in VAS and ODI score preoperatively between the different types (P＞0.05)，but significant differences was found in VAS and ODI score during postoperative and final follow-up (P＜0.01).Conclusion Somatic referred pain is more common in patients with OVCF，Type A is the most common type，and Type D and Type E are relatively rare.PKP is an effective treatment for OCVF with somatic referred pain.

Key words： osteoporosis spinal fracture referred pain percutaneous kyphoplasty

通讯作者: 陆声

作者简介: 施荣茂(1987－ )，男，主治医师，联勤保障部队第920医院附属骨科医院，650032。

引用本文:

施荣茂，陈太邦，梁金龙，陆维，徐永清，陆声 *. 骨质疏松椎体压缩性骨折躯体牵涉痛的临床分型及治疗[J]. 实用骨科杂志, 2019, 25(3): 201-204.
Shi Rongmao，Chen Taibang，Liang Jinlong，et al. Clinical Classification and Treatment of Somatic Referred Pain of Osteoporotic Vertebral Compression Fracture. sygkzz, 2019, 25(3): 201-204.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2019/V25/I3/201

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