Effect of Paravertebral Blocks Combined with Percutaneous Kyphoplasty on Thoracic Vertebral Fractures Complicated with Costal Pain.

Abstract

Vertebral augmentation surgery has shown good results for treating osteoporotic vertebral compression fractures, but its effect on relieving costal pain is not satisfactory. To study the clinical efficacy of combining thoracic paravertebral nerve blocks (TPVNBs) with percutaneous kyphoplasty (PKP) in the treatment of thoracic vertebral fractures with costal pain, providing a reference for clinical diagnosis and management. A retrospective study. A single medical center in China. This was a retrospective cohort study. Patients who underwent PKP for thoracic fractures with costal pain at Quzhou People's Hospital from March 1, 2021, to March 1, 2023, were included. They were divided into a paravertebral block group (PVB group) and a control group. Pain intensity was measured using the Visual Analog Scale (VAS) before surgery and at multiple postoperative intervals. Physical function was evaluated using the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) tool, and treatment satisfaction was recorded using the Modified Macnab Criteria. A total of 73 patients met the inclusion criteria, with 35 in the PVB group and 38 in the control group. Preoperative VAS scores for back pain and costal pain were similar between the 2 groups. Postoperatively, both groups experienced significant pain reduction, but the PVB group had better costal pain relief in the early follow-up period (within the first 3 months) and greater early functional recovery. At 12 months, the satisfaction rate was higher in the PVB group (94.3%) than in the control group (76.3%). The study's retrospective design, small sample size, short follow-up period, and incomplete understanding of pathogenesis limit the generalizability and long-term assessment of its findings. A combination of PKP and PVB can significantly improve the pain relief rate and the quality of life in the early postoperative period of patients with thoracic vertebral fractures and costal pain.