经皮椎体成形术治疗老年骨质疏松性椎体骨折  

Percutaneous Vertebroplasty in the Treatment of Osteoporotic Vertebral Fractures

作　　者：江朝根[1] 吴渭贤[1] 叶志伟[1] 朱希松[1] 徐德洪[2] 

机构地区：[1]浙江省衢州市人民医院放射科,浙江衢州324000 [2]浙江省衢州市人民医院骨二科,浙江衢州324000

出　　处：《实用放射学杂志》2008年第8期1108-1111,共4页Journal of Practical Radiology

摘　　要：目的探讨经皮椎体成形术（PVP）治疗老年骨质疏松性椎体骨折的价值。方法27例老年骨质疏松症患者共33节椎体骨折，均经MRI、CT及平片证实。在透视监视下经椎弓根行椎体穿刺，注入粉（g）：液（ml）：硫酸钡粉（g）为15：10：3的聚甲基丙烯酸甲酯（PMMA），术后即刻摄X线正侧位片，1d后CT观察PMMA分布渗漏状况，定期观察疗效和椎体高度。结果PVP技术成功率100％，PMMA平均注入量4．6ml（2．3～7．5mL），术后1dCT证实椎体周围PMMA少量渗漏7节，但无临床症状。术后1d，所有病例腰背部疼痛明显减轻，平均随访8个月，疼痛均无复发，椎体高度无进一步塌陷。结论PVP对治疗老年骨质疏松性椎体骨折所致的腰背疼痛是有效的。Objective To evaluate the key value technique of percutaneous vertebroplasty（PVP） in patients with osteoporotic vertebral fractures. Methods 33 vertebrae fractures in 27 patients with osteoporosis proved by MRI, CT and plain radiography. PVP was performed under C -arm flouroscopy guidance in all cases. During PVP, polymethylmethacrylate（PMMA ） was injected in the disordered vertebrae,and PMMA was mixture with the proportion of powders, liquid and powers of barium sulphate as 15 ： 10 ： 3 . CT examinations were done 1 d after operation to observe PMMA distribution in vertebrae and whether leakage. The efficacy of PVP and the heights of vertebrae was evaluated during follow - up. Results The successful rate of technique of PVP was 100%. 4.6 ml of PMMA in average was respectively injected in each vertebra. No serious complications related to the technique occurred, except 7 vertebrae with asympotomatic PMMA leakage around vertebrae demonstrated by CT. The pain on lumbodosum was relieved in all patients 1 d later. The height of vertebrae was kept to normal during follow - up （average 8 months）. Conclusion PVP is an effective and safe procedure for treating persistent painful osteoporotic vertebral fractures.

关 键 词：椎体成形术 聚甲基丙烯酸甲酯 骨质疏松 骨折 

分 类 号：R681[医药卫生—骨科学] R683[医药卫生—外科学]