Zhang X, Li ZX, Yin LJ, Chen H. Selective nerve block for the treatment of neuralgia in Kummell’s disease: A case report. World J Clin Cases 2022; 10(21): 7523-7530 [PMID: 36158019 DOI: 10.12998/wjcc.v10.i21.7523]
Corresponding Author of This Article
Hui Chen, MD, Doctor, Department of Anesthesiology and Perioperative Medicine, Shanghai The Fourth People’s Hospital Affiliated to Tongji University School of Medicine, No. 1279 Sanmen Road, Hongkou District, Shanghai 200434, China. chenhui_md@163.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 26, 2022; 10(21): 7523-7530 Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7523
Selective nerve block for the treatment of neuralgia in Kummell’s disease: A case report
Xin Zhang, Zong-Xi Li, Li-Jun Yin, Hui Chen
Xin Zhang, Zong-Xi Li, Li-Jun Yin, Department of Anesthesiology and Perioperative Medicine, Shanghai The Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai 200434, China
Li-Jun Yin, Department of Anesthesiology, Ningbo Women and Children’s Hospital, Ningbo 315012, China
Hui Chen, Department of Anesthesiology and Perioperative Medicine, Shanghai The Fourth People’s Hospital Affiliated to Tongji University School of Medicine, shanghai 200434, China
Author contributions: Zhang X and Chen H performed the treatments in this study; Chen H and Zhang X designed the study; Li ZX collected the clinical data of the patient; Zhang X, Li ZX, Yin LJ, and Chen H collaborated on the primary manuscript; Zhang X and Yin LJ revised the manuscript; Chen H checked the revised manuscript; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui Chen, MD, Doctor, Department of Anesthesiology and Perioperative Medicine, Shanghai The Fourth People’s Hospital Affiliated to Tongji University School of Medicine, No. 1279 Sanmen Road, Hongkou District, Shanghai 200434, China. chenhui_md@163.com
Received: January 24, 2022 Peer-review started: January 24, 2022 First decision: March 23, 2022 Revised: April 1, 2022 Accepted: June 3, 2022 Article in press: June 3, 2022 Published online: July 26, 2022 Processing time: 168 Days and 4.3 Hours
Abstract
BACKGROUND
Neuralgia is frequently noted in patients with Kummell’s disease, and its mechanism is complex, rendering it challenging to treat. Percutaneous kyphoplasty (PKP) has been widely used to treat osteoporotic vertebral compression fractures with satisfactory outcomes. However, it is not optimal for managing severely collapsed vertebrae, as cement injection may not be feasible. This report describes the use of a selective nerve block for the treatment of neuralgia caused by severely collapsed vertebrae in a patient with Kummell’s disease.
CASE SUMMARY
In our patient, three vertebrae were involved. The collapse of T11 was particularly severe. After managing T8 and T9 using PKP, these two segments were effectively strengthened; consequently, back pain was significantly relieved. However, the structure and strength of T11 could not be effectively restored using a minimally invasive surgical method because there was little room for cement injection. This caused obvious neuralgia according to the postoperative status of the PKP. Thus, we performed selective nerve blocks for the treatment of neuralgia, which resulted in satisfactory outcomes.
CONCLUSION
Selective nerve block may be a possible therapeutic strategy for neuralgia due to severely collapsed vertebrae in Kummell’s disease.
Core Tip: Percutaneous kyphoplasty is not optimal for managing severely collapsed vertebrae, as cement injection may not be feasible. In our patient, the structure and strength of T11 could not be effectively restored by using a minimally invasive surgical method. However, it caused obvious neuralgia. Thus, a selective nerve block was used to treat the neuralgia, which led to satisfactory outcomes. These results indicate that selective nerve block may be an optional therapeutic measure for neuralgia due to severely collapsed vertebrae in patients with Kummell’s disease who are not candidates for conventional surgery.
