Clinical Efficacy Of Radiofrequency Ablation Of The Dorsal Ramus Of Spinal Nerve Combined With Nerve Block On Osteoporotic Vertebral Compression Fracture

Objective:To compare the efficacy and safety of radiofrequency ablation combined with nerve block(RFNB)of the dorsal ramus of spinal nerve and percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods:A total of 60 OVCF patients hospitalized in the Department of Pain,The First Affiliated Hospital of Nanchang University from June 2020 to August 2021 were randomly divided into RFNB group(R group)and PKP group(P group),with 30 patients in each group.Visual analogue scale(VAS)and the Oswestry disability index(ODI)were used to assess the degree of pain and spinal function before surgery and at 1 day,1 week,1 month,3 months,and 6 months after surgery.The quality of life of the patients before surgery and at 1,3,and 6 months after surgery was assessed by using Short-Form 12-Item health survey(SF-12).The modified MacNab standard was used to evaluate the efficacy and calculate the good rate of efficacy.Finally,the safety was evaluated by operation time,bleeding volume and complications.Results:29 patients were followed up in each group,and there was no significant difference in general condition between the two groups.The good rate of R group and P group at 6 months after surgery were 93.10%and 96.55%,and there was no statistical significance between them(P>0.05).When compared within groups,postoperative VAS score and ODI index were significantly lower than those before surgery,and the PCS and MCS scores of SF-12 were significantly increased(P<0.05).On the other hand,There were no significant differences in VAS scores,PCS and MCS scores between the two groups(P>0.05),but the ODI index of P group was lower than that of R group at 1 day,1 week and 1 month after surgery(P<0.05),and there was no significant difference in ODI index at 3 months and 6 months after surgery(P>0.05).In addition,the operation time and bleeding volume in group R were significantly less than group P(P<0.05).There were 2 patients with new vertebral fractures in both groups after surgery,and there was no statistically significance(P>0.05).In addition,there were 2 cases of bone cement leakage in group P and 1 case of lumbar numbness in group R.Conclusion:The therapies of PKP and RFNB are effective in the treatment of OVCF,and there is no significant difference between them for pain relief and quality of life improvement.Although PKP can better improve spinal function in the early postoperative stage,there is no significant difference between the two treatments at 3 months after the operation.At the same time,RFNB is more minimally invasive,safer,so it is worthy of clinical promotion in the minimally invasive surgical treatment of OVCF patients.