Clinical Efficacy of Ramus Communicans Nerve Block in Patient with Vertebral Compression Fracture

Choi, Sang Eun; Suh, Jung Wook; Hwang, Sung Mi; Lim, So Young; Shin, Keun Man

Abstract

BACKGROUND
Vertebral compression fractures can cause severe mechanical pain in spite of conservative treatments. Although vertebroplasty is an effective treatment for vertebral compression fractures, it is not strongly indicated in some patients. This study was performed to verify the usefulness of ramus communicans nerve block in patients suffering from back pain due to a vertebral compression fracture. METHODS: A randomized clinical trial was carried out in 34 patients with a vertebral compression fracture after conservative therapy had failed. Nerve blocks on the ramus communicans corresponding to vertebral compression fracture were performed once a week for 2 consecutive weeks under C-arm fluoroscopic guidance. The pain scores were evaluated before and after each nerve block using a 100 mm VAS (visual analog scale), and the side effects were also checked. RESULTS: All patients tolerated the procedures well. The VAS pain scores were significantly lower than that at the baseline (P< 0.05) after the 1st and 2nd nerve blocks, and there were no serious procedure-related complications. CONCLUSIONS: Prompt and prolonged improvement in pain was achieved, with no serious complications during or after the procedure. These results support the effectiveness and safety of ramus communicans nerve block for patients with a persistently painful vertebral compression fracture. Therefore, ramus communicans nerve block can be one of the treatment modalities for patients with back pain due to a vertebral compression fracture.