经皮椎体成形术的临床应用  

Clinical Application of Percutaneous Vertebroplasty

作　　者：王振堂[1] 邱洪明[1] 林琳[1] 郝强[1] 陈炜[1] 

机构地区：[1]第二军医大学长海医院放射科,200433

出　　处：《中国医学计算机成像杂志》2005年第4期269-272,共4页Chinese Computed Medical Imaging

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.材料和方法:对106例患者共141个椎体在DSA监视下行椎体成形术,其中椎体转移性肿瘤83例,老年性压缩性骨折23例.结果:106例手术全部成功,疼痛完全缓解98例,部分缓解8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.141个椎体中骨水泥外漏发生率为14.9%,其中出现椎间盘漏8个椎体、硬膜外漏9个椎体、椎旁静脉丛2个椎体、椎旁软组织2个椎体,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.Purpose： To evaluate the efficacy of percutaneous vertebroplasty for treating vertebral compression fractures, vertebra metastatic neoplasms and its clinical curative effects. Materials and Methods： Among 106 cases （58 men and 48 women; ages 35- 84, mean age 63.2 years）, 141 vertebrals with metastatic neoplasms or with vertebral osteoporosis were infused with methacrylate guided by DSA during 43 months . 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 81 patients treated for malignancies, 73 showed marked pain relief, 8 moderate relief . 23 patients with vertebral osteoporosis demonstrated moderate or complete pain relief. The cement leakage observed on radiographs included slight leakage to the adjacent disc（8 of 141, 5.7% ）the perivertebral venous（2 of 141, 1.4%）, the paravertebral soft tissues（2 of 141, 1. 496） and the epidural fat（9 of 141, 6. 496 ）. Conclusion： Percutaneous vertebroplasty can significantly relieve the pain of 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：椎体骨折 脊柱转移瘤 介入放射学 经皮椎体成形术 临床应用 椎体转移性肿瘤 经皮椎体成型术 压缩性骨折 完全缓解 治疗效果 

分 类 号：R687[医药卫生—骨科学]