Spine

Medial branch blocks may help reduce remnant pain after vertebroplasty

LYON, France — When remnant pain after vertebroplasty for an osteoporotic vertebral compression fracture became intolerable, patients who underwent a prophylactic medial branch block showed improvement in pain within 1 week, according to data presented at the EuroSpine Annual Meeting, here.

“Pain can come from the strained facet joint, but can be improved with MBB [medial branch block], Chang Hyun Oh, MD said.

In 81% of patients, Oh and colleagues administered the prophylactic medial branch blocks based on the site of the patients’ postoperative pain shown on a postoperative pain map.

Oh also presented results of the second part of the study that analyzed the prevalence of remnant pain in patients after vertebroplasty. The rates of remnant pain are as high 24% in one study in the literature, he said.

For the part of the study that included the MBB results, Oh and colleagues randomized 87 patients with remnant pain after vertebroplasty to either undergo MBB for prophylactic pain relief after vertebroplasty or not. They were followed up at 3 months. To be included, patients needed clinical signs of an osteoporotic vertebral compression fracture without motor weakness confirmed on exam, and they had to have failed 2 weeks of conservative therapy. The vertebroplasty technique the surgeons used involved injection of polymethylmethacrylate bone cement, Oh said.

Reduced pain based on the VAS scores after 1 months and 3 months postoperatively were similar to those at the 1-week follow-up in the MBB group, according to the abstract. – by Susan M. Rapp

Reference:

Ji GY. Paper #24. Presented at: EuroSpine Annual Meeting; Oct. 1-3, 2014; Lyon, France.

Disclosure: Oh has no relevant financial disclosures.

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Josh Sandberg

Josh Sandberg is the President of Ortho Sales Partners and Partner for The De Angelis Group. He also serves as Co-Founder and Editor of OrthoSpineNews.

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