Constructing a Novel Multimodal Analgesic Strategy for OVCF: A Theoretical Framework for the Synergistic Action of Paravertebral Block, Celecoxib and Ozone

Abstract

Osteoporotic vertebral compression fracture (OVCF) is a significant cause of chronic pain in elderly patients. Its complex pain mechanisms often render single-mode analgesia insufficiently effective. This study proposes a triple analgesic regimen based on paravertebral block (PVB), oral celecoxib, and medical ozone injection, exploring the synergistic mechanisms from a neurobiological perspective. Through theoretical modeling, we systematically analyzed the mechanical, inflammatory, and neuropathic pain mechanisms of OVCF, clarifying the distinct action targets of the three interventions at different levels: PVB blocks neural signal transmission, celecoxib inhibits the COX-2/PGE2 inflammatory pathway, and ozone remodels the local microenvironment. The study constructed a three-level synergistic model, using the inhibition of dorsal root ganglion (DRG) neuronal excitability as the core indicator, demonstrating that the triple analgesic regimen achieves maximal suppression of DRG neurons through multi-target synergy. This research provides new insights for OVCF analgesia and lays a theoretical foundation for subsequent studies.