侵袭性脊柱血管瘤的外科治疗  

Surgical treatment of invasive spinal hemangioma

作　　者：曹云[1] 卿培东[1] 彭五四[1] 羊东[1] 

机构地区：[1]绵阳市骨科医院脊柱骨肿瘤科,四川绵阳621000

出　　处：《颈腰痛杂志》2016年第2期136-139,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨侵袭性脊柱血管瘤的外科手术方式和临床价值。方法 9例有神经损害的侵袭性血管瘤患者,术前经X片、CT和（或）MRI检查,诊断明确,均行后路减压联合开放椎体成形术治疗,其中3例先行后路减压内固定术（A组）,6例先行开放椎体成形术（B组）,比较患者术前、术后VAS疼痛评分、Frankel脊髓损伤分级评分、两种手术方式术中出血量及手术时间。结果 9例患者术后VAS评分由术前平均7.5分降至术后平均2.3分,术后神经功能不同程度恢复,术中出血量A组80-100ml,B组50-90 ml,手术时间A组90-100 Min,B组50-100 Min,两组术后复查均无骨水泥渗漏,无椎管内占位,随访7-48个月,平均21.3个月,所有患者术后肿瘤未见复发,病变椎体高度未见丢失。结论开放椎体成形术联合后路减压内固定治疗侵袭性脊柱血管瘤效果良好,先行开放椎体成形术可减少术中出血量,而先行椎板切除减压能进一步降低椎体后壁破损患者的脊髓损伤的风险。Objective To investigate the surgical methods and clinical value of invasive spinal hemangioma. Methods Clinical data of 9 patients with invasive spinal hemangioma admitted in our hospital from May 2009 to July 2013 were retrospectively reviewed. Diagnosis was made by preoperative X-ray,CT and/or MRI. All 9 patients underwent open vertebroplasty combined with posterior decompression,including 3 cases undergoing open vertebroplasty first（A group） and 6cases undergoing posterior decompression first（B group）. The VAS pain score and Frankel score were compared before and after operation. The intraoperation bleeding and operation time were compared between A group and B group. Results The VAS score was decreased from 7.5 before operation to 2.3 after operation,and the neurological function was recovered in various degree after operation. The intraoperation bleeding of A group was 80-100ml and B group was 50-90 ml.The operation time of A group was 90-100 min and B group was 50-100 min.There was no leakage of bone cement,no intraspinal space occupying. Patients were followed up for 7-48 months with a average 21.3 months,there was tumor recurrence,no loss of verbebral height in all patients.Conclusion Open vertebroplasty combined with posterior decompression and internal fixation for treatment of invasive spinal hemangioma is effective and safe,and first undergoing open vertebroplasty can reduce intraoperation bleeding while first undergoing open vertebroplasty can reduce the risk of spinal cord injury in patients with vertebral posterior wall broke.

关 键 词：侵袭性脊柱血管瘤 椎体成形术 后路减压 

分 类 号：R681.55[医药卫生—骨科学]