Gray Ramus Communicans Nerve Block for Acute Pain Control in Vertebral Compression Fracture
<i>Background and Objectives</i>: The current options for acute pain control of vertebral compression fracture include hard brace, vertebroplasty, early surgery, and analgesic injection. We hypothesize that the gray ramus communicans nerve block (GRNB) controls the acute pain experienced...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-07-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/57/8/744 |
| _version_ | 1797522994394824704 |
|---|---|
| author | Dou-Young Park Il Choi Tae-Gyum Kim Woo-Jae Kim Il-Young Shin Eun-Kyung Khil |
| author_facet | Dou-Young Park Il Choi Tae-Gyum Kim Woo-Jae Kim Il-Young Shin Eun-Kyung Khil |
| author_sort | Dou-Young Park |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: The current options for acute pain control of vertebral compression fracture include hard brace, vertebroplasty, early surgery, and analgesic injection. We hypothesize that the gray ramus communicans nerve block (GRNB) controls the acute pain experienced during vertebral compression fractures. This study assessed the time course of pain control after injection and evaluated the risk factors affecting pain control failure. <i>Materials and methods:</i> Sixty-three patients (24 male, 66.19 ± 15.17 y) with a thoracolumbar vertebral fracture at the T10-L5 spine, who presented to our hospital from November 2018 to October 2019, were included in this retrospective cohort study. GRNB was performed within 1 week of the trauma. The patients were followed up on days 3, 14, 30, 90, and 180 and assessed with the serial visual analog scale (VAS, resting and motion), Oswestry Low Back Disability (ODI) questionnaire, and Roland–Morris Disability Questionnaire (RDQ). The failure group was defined by the need for an additional block or cement injection after a single GRNB. The failure group’s risk factors, such as body mass index, initial thoracolumbar injury classification and severity score, Kummel’s disease, age, bone marrow density (BMD), and underlying disease, were analyzed. <i>Results</i>: The motion VAS score improved from preoperative to three months post-procedure, but the resting VAS was affected by the procedure for only three days. The quality of life index improved at postoperative six months. A lower BMD was the only risk that affected treatment failure in the logistic regression analysis (<i>p</i> = 0.0038). <i>Conclusion</i>: The effect of GRNB was maintained even at three months after trauma based on motion VAS results. The only risk factor identified for GRNB failure was lower BMD. |
| first_indexed | 2024-03-10T08:37:11Z |
| format | Article |
| id | doaj.art-84d6c1e814c9408b97fbfeb87338af03 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T08:37:11Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-84d6c1e814c9408b97fbfeb87338af032023-11-22T08:35:27ZengMDPI AGMedicina1010-660X1648-91442021-07-0157874410.3390/medicina57080744Gray Ramus Communicans Nerve Block for Acute Pain Control in Vertebral Compression FractureDou-Young Park0Il Choi1Tae-Gyum Kim2Woo-Jae Kim3Il-Young Shin4Eun-Kyung Khil5Department of Neurological Surgery, Dongtan Sacred Heart Hospital, Hallym University Hwaseong, Hwaseong 18450, KoreaDepartment of Neurological Surgery, Dongtan Sacred Heart Hospital, Hallym University Hwaseong, Hwaseong 18450, KoreaDepartment of Neurosurgery, Ace Hospital, Ansan 39177, KoreaDepartment of Neurosurgery, Youngdong Hospital, Hwaseong 38611, KoreaDepartment of Neurological Surgery, Dongtan Sacred Heart Hospital, Hallym University Hwaseong, Hwaseong 18450, KoreaDepartment of Radiology, Dongtan Sacred Heart Hospital, Hallym Unverisity, Hwaseong 18450, Korea<i>Background and Objectives</i>: The current options for acute pain control of vertebral compression fracture include hard brace, vertebroplasty, early surgery, and analgesic injection. We hypothesize that the gray ramus communicans nerve block (GRNB) controls the acute pain experienced during vertebral compression fractures. This study assessed the time course of pain control after injection and evaluated the risk factors affecting pain control failure. <i>Materials and methods:</i> Sixty-three patients (24 male, 66.19 ± 15.17 y) with a thoracolumbar vertebral fracture at the T10-L5 spine, who presented to our hospital from November 2018 to October 2019, were included in this retrospective cohort study. GRNB was performed within 1 week of the trauma. The patients were followed up on days 3, 14, 30, 90, and 180 and assessed with the serial visual analog scale (VAS, resting and motion), Oswestry Low Back Disability (ODI) questionnaire, and Roland–Morris Disability Questionnaire (RDQ). The failure group was defined by the need for an additional block or cement injection after a single GRNB. The failure group’s risk factors, such as body mass index, initial thoracolumbar injury classification and severity score, Kummel’s disease, age, bone marrow density (BMD), and underlying disease, were analyzed. <i>Results</i>: The motion VAS score improved from preoperative to three months post-procedure, but the resting VAS was affected by the procedure for only three days. The quality of life index improved at postoperative six months. A lower BMD was the only risk that affected treatment failure in the logistic regression analysis (<i>p</i> = 0.0038). <i>Conclusion</i>: The effect of GRNB was maintained even at three months after trauma based on motion VAS results. The only risk factor identified for GRNB failure was lower BMD.https://www.mdpi.com/1648-9144/57/8/744osteoporosiscompression fracturebone marrow densityserial visual analog scaleOswestry Low Back Disability QuestionnaireRoland–Morris Disability Questionnaire |
| spellingShingle | Dou-Young Park Il Choi Tae-Gyum Kim Woo-Jae Kim Il-Young Shin Eun-Kyung Khil Gray Ramus Communicans Nerve Block for Acute Pain Control in Vertebral Compression Fracture Medicina osteoporosis compression fracture bone marrow density serial visual analog scale Oswestry Low Back Disability Questionnaire Roland–Morris Disability Questionnaire |
| title | Gray Ramus Communicans Nerve Block for Acute Pain Control in Vertebral Compression Fracture |
| title_full | Gray Ramus Communicans Nerve Block for Acute Pain Control in Vertebral Compression Fracture |
| title_fullStr | Gray Ramus Communicans Nerve Block for Acute Pain Control in Vertebral Compression Fracture |
| title_full_unstemmed | Gray Ramus Communicans Nerve Block for Acute Pain Control in Vertebral Compression Fracture |
| title_short | Gray Ramus Communicans Nerve Block for Acute Pain Control in Vertebral Compression Fracture |
| title_sort | gray ramus communicans nerve block for acute pain control in vertebral compression fracture |
| topic | osteoporosis compression fracture bone marrow density serial visual analog scale Oswestry Low Back Disability Questionnaire Roland–Morris Disability Questionnaire |
| url | https://www.mdpi.com/1648-9144/57/8/744 |
| work_keys_str_mv | AT douyoungpark grayramuscommunicansnerveblockforacutepaincontrolinvertebralcompressionfracture AT ilchoi grayramuscommunicansnerveblockforacutepaincontrolinvertebralcompressionfracture AT taegyumkim grayramuscommunicansnerveblockforacutepaincontrolinvertebralcompressionfracture AT woojaekim grayramuscommunicansnerveblockforacutepaincontrolinvertebralcompressionfracture AT ilyoungshin grayramuscommunicansnerveblockforacutepaincontrolinvertebralcompressionfracture AT eunkyungkhil grayramuscommunicansnerveblockforacutepaincontrolinvertebralcompressionfracture |