World neurosurgery · 2026
Clinical effects of posterior medial branch block of spinal nerve on repeated punctures during percutaneous vertebroplasty: a retrospective study based on patient-reported outcomes and clinical complications.
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Liu Xiaolei, Yu Xiao, Bi Lei, Yang GuangXu, Sun Fan, Wang Haibin, Cao XiaoJian
Аннотация
OBJECTIVE: To evaluate the effects of spinal nerve posterior medial branch block (PMBB) on repeated puncture attempts during percutaneous vertebroplasty, where repeated punctures were defined as ≥ 3 successful unilateral punctures (with the needle tip positioned at the 9-11 or 1-3 o'clock position of the pedicle projection).
METHODS: 152 patients with osteoporotic vertebral compression fractures (OVCFs) underwent repeated punctures during percutaneous vertebroplasty were retrospectively analyzed. The patients were divided into the PMBB group (n=78) and the Non-PMBB group (n=74) according to whether PMBB was performed on repeated punctures. Demographic data and surgical outcomes were compared between them. All patients were followed up for 1 month. The patient-reported outcomes [Oswestry disability index (ODI) and visual analog scale (VAS) score] and clinical complications (residual pain proportion, rate and duration of pain medication) were compared between the two groups.
RESULTS: No significant differences were observed in the demographic data and imaging parameters between the two groups (P > 0.05). In terms of surgical outcomes, the surgical duration (39 ± 7.3 min) of the PMBB group was higher than that (36 ± 7.0 min) of the Non-PMBB group (P < 0.05). As for patient-reported outcomes and clinical complications during 1 month postoperatively follow-up period, there were no significant differences in VAS score and ODI between the two groups at preoperation and 1 month postoperatively, but the VAS score and ODI at 1 day (2.0 ± 0.8, 22 ± 4.8) and 7 days (1.6 ± 0.8, 19 ± 4.1) postoperatively, and residual pain proportion (5.1%), rate (3.8%) and duration (2.7 ± 0.6) of pain medication in the PMBB group were better than those (3.0 ± 0.7, 31 ± 4.7, 2.4 ± 0.7, 25 ± 3.9, 16%, 15%, 4.6 ± 1.0) in the Non-PMBB group, respectively (P < 0.05).
CONCLUSION: For repeated punctures during percutaneous vertebroplasty, although the PMBB increased the surgical duration, it can effectively relieve the postoperative pain. More importantly, PMBB can significantly reduce the residual pain proportion, the rate and duration of pain medication.
METHODS: 152 patients with osteoporotic vertebral compression fractures (OVCFs) underwent repeated punctures during percutaneous vertebroplasty were retrospectively analyzed. The patients were divided into the PMBB group (n=78) and the Non-PMBB group (n=74) according to whether PMBB was performed on repeated punctures. Demographic data and surgical outcomes were compared between them. All patients were followed up for 1 month. The patient-reported outcomes [Oswestry disability index (ODI) and visual analog scale (VAS) score] and clinical complications (residual pain proportion, rate and duration of pain medication) were compared between the two groups.
RESULTS: No significant differences were observed in the demographic data and imaging parameters between the two groups (P > 0.05). In terms of surgical outcomes, the surgical duration (39 ± 7.3 min) of the PMBB group was higher than that (36 ± 7.0 min) of the Non-PMBB group (P < 0.05). As for patient-reported outcomes and clinical complications during 1 month postoperatively follow-up period, there were no significant differences in VAS score and ODI between the two groups at preoperation and 1 month postoperatively, but the VAS score and ODI at 1 day (2.0 ± 0.8, 22 ± 4.8) and 7 days (1.6 ± 0.8, 19 ± 4.1) postoperatively, and residual pain proportion (5.1%), rate (3.8%) and duration (2.7 ± 0.6) of pain medication in the PMBB group were better than those (3.0 ± 0.7, 31 ± 4.7, 2.4 ± 0.7, 25 ± 3.9, 16%, 15%, 4.6 ± 1.0) in the Non-PMBB group, respectively (P < 0.05).
CONCLUSION: For repeated punctures during percutaneous vertebroplasty, although the PMBB increased the surgical duration, it can effectively relieve the postoperative pain. More importantly, PMBB can significantly reduce the residual pain proportion, the rate and duration of pain medication.