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目的:探讨骨质疏松性主体压缩骨折患者的致痛机制及PKP镇痛原理。方法:取我院2015年2月~2015年12月收治的骨质疏松性椎体压缩骨折患者52例,随机分为对照组和观察组,比较两组患者手术前、术后3d及术后随访6个月的视觉模拟疼痛评分、椎体前缘高度的恢复、脊柱后凸角度(Cobb角)变化及卧床时间。结果:两组患者患椎椎体信号改变、腰椎骨关节增生及腰背肌间隙MRI信号改变存在显著差异(P<0.05),而患者的年龄及BMD差异不明显,观察组的平均卧床时间远远短于对照组;两组患者手术前、术后3d及术后随访6个月的VAS评分、椎体前缘高度、Cobb角变化的差异有统计学意义(P<0.05)。结论:压缩骨折患椎椎体内的压力增加、椎体的形变、骨质疏松及退行性病变导致腰椎失稳是OVCFs的主要致痛机制,PKP治疗能通过椎体减压、脊柱重塑等对该类患者镇痛。
Objective: To investigate the mechanism of pain induced by osteoporotic compression fractures and the principle of PKP analgesia. Methods: Fifty-two patients with osteoporotic vertebral compression fractures admitted from February 2015 to December 2015 in our hospital were randomly divided into control group and observation group. The changes of preoperative and postoperative 3d and postoperative The visual analogue pain score, the recovery of anterior vertebral height, the change of Cobb angle and the time of bed rest in 6 months follow-up. Results: There were significant differences in signal changes of lumbar vertebral bodies, lumbar joint hyperplasia and MRI signal changes in lumbar and back muscle between the two groups (P <0.05), but there was no significant difference in age and BMD among the two groups. The mean bed rest time (P <0.05). There was significant difference in VAS score, anterior vertebral height and Cobb angle between the two groups before and after operation and after 6 months of follow-up. CONCLUSIONS: Compression fracture is the major mechanism of pain in OVCFs because of increased pressure in vertebral body, deformation of vertebral body, osteoporosis and degenerative diseases. Lumbar instability is the main mechanism of pain in OVCFs. PKP can be used to reduce stress and spinal remodeling Analgesia to these patients.