椎体成形术的临床应用  

Clinical application of percutaneous vertebroplasty

作　　者：王振堂[1] 林琳[1] 郝强[1] 陈炜[1] 叶华[1] 

机构地区：[1]第二军医大学长海医院放射科,上海200433

出　　处：《中华放射学杂志》2004年第12期1301-1304,共4页Chinese Journal of Radiology

摘　　要：目的　探讨经皮椎体成形术的穿刺方法及治疗椎体转移性肿瘤和老年性压缩性骨折的临床疗效。方法　对 81例患者 (男 4 7,女 34,年龄 35～ 84 ,平均 6 1 2岁 )共 110个椎体行椎体成形术 ,其中椎体转移性肿瘤 6 1例 ,老年性压缩性骨折 2 0例 ,在DSA监视下进行。结果　 81例手术全部成功 ,疼痛完全缓解 78例 ,部分缓解 3例。胸椎注入骨水泥为 2～ 4ml,平均 3 1ml、腰椎注入 3～ 8ml,平均 4 85ml,骶椎 4ml。 81例中出现椎间盘漏 6例、硬膜外漏 8例、椎旁静脉丛 2例、椎旁软组织 2例 ,但均未出现临床症状。结论　经皮椎体成型术对缓解或消除由椎体病变引起的疼痛有明显的治疗效果。无神经症状的骨水泥外漏可不视为并发症。Objective To evaluate the efficacy of percutaneous vertebroplasty for treating the vertebral compression fractures and vertebral metastatic neoplasms, and to assess its clinical curative effects Methods Among 81 cases (47 men and 34 women; ages 35～84, mean age 61 2 years), 110 vertebrae with metastatic neoplasms (61 cases) or vertebral osteoporosis (20 cases) were infused with methacrylate guided by DSA Effect of the operations was observed closely after the procedures Results The procedures were successful in all the involved patients and no significant complications were noted clinically Among the 61 patients treated for malignancies, 58 showed marked pain relief and 3 moderate pain relief 20 patients with vertebral osteoporosis demonstrated complete pain relief The cement leakage observed on radiographs included slight leakage to the adjacent disc (6 of 110, 5 5%), the epidural fat (8 of 110, 7 3%), the perivertebral venous plexus (2 of 110, 1 8%), and the paravertebral soft tissues (2 of 110, 1 8%) Conclusion Percutaneous vertebroplasty can significantly relieve the pain in patients with osteoporotic fractures caused by the malignancies and the vertebral osteoporosis We suggest that slight PMM leaks, when not symptomatic, should not be considered as complications

关 键 词：临床应用 椎体成形术 老年性 转移性肿瘤 骨水泥 压缩性骨折 疼痛 平均 监视 DSA 

分 类 号：R687[医药卫生—骨科学]