经皮椎体成形术治疗Ⅱ型症状性椎体血管瘤的疗效观察  

作　　者：赵立来[1] 童培建[2] 肖鲁伟[2] 朱求亮[1] 娄云龙[1] 

机构地区：[1]浙江省安吉县人民医院骨科,313300 [2]浙江中医药大学附属浙江省中医院骨科,310006

出　　处：《浙江临床医学》2017年第8期1457-1459,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨椎体成形术治疗Ⅱ 型症状性椎体血管瘤的中长期临床疗效.方法 回顾性分析2012年1月至2015年10月应用椎体成形术治疗16例Ⅱ型椎体血管瘤患者的临床资料.结果 所有患者伤口均Ⅰ期愈合,1例出现神经根损伤,2周后症状基本缓解,无深静脉栓塞及肺栓塞,影像学提示骨水泥充填满意,1例发生椎旁骨水泥渗漏,无临床不适症状,未见邻椎骨折及病灶复发,所有患者术后疼痛缓解明显,术后6h均可在支具保护下行走,视觉疼痛模拟评分（VAS）及日本骨科协会评估治疗分数（JOA评分）、Oswestry功能障碍指数（ODI）分别由术前的（8.4±1.2）分、（15.3±1.7）分和（83.3±4.6）%改善至术后第2天的（3.1±1.1）分、（24.9±1.6）分和（32.3±5.4）%,差异有统计学意义（P〈0.05）,16例均得到随访,时间12-48个月,平均26.5个月,VAS和JOA评分、ODI分别为（2.2±0.8）分、（26.4±2.3）分和（29.2±4.3）%,与术后第2天比较差异均无统计学意义（P〉0.05）.结论 椎体成形术治疗Ⅱ型椎体血管瘤作为一种相对安全,创伤小,疼痛缓解满意,术后恢复快,有良好的应用前景.Objective To investigate the clinical efficacy of percutaneous vertebroplasty（PVP）for Ⅱ type symptomatic vertebral hemangioma. Methods The clinical data of 16 patients with type Ⅱ vertebral hemangioma treated with vertebroplasty from January 2012 to October 2015 were retrospectively analyzed. Results Incision of all patients healed normally without infection. The degree of back pain decreased remarkably after PVP. The mean time of ambulation was 6 hours at post-operation with the protection of brace. Cement leakage occurred in 1 case with no symptom. Transient neurological deficits in 1 case,the symptom disappeared 2 weeks after surgery. VAS and JOA scores,ODI improved statistically from preoperative （8.4±1.2）,（15.3±1.7）and（83.3±4.6）% to（3.1±1.1）,（24.9±1.6）and（32.3±5.4）% respectively at the 2nd day after the operation. All the patients were followed up,and the duration ranged from 12 to 48 months,with a mean of 26.5 months. At the latest follow-up,the VAS and JOA scores and ODI were（2.2±0.8）,（26.4±2.3）and（29.2±4.3）% respectively,which had no obvious difference compared to those results at the 2nd day after operation. Conclusion PVP can significantly relieve intractable back pain caused by vertebral hemangioma. It is a safe and effective minimal invasive procedure which shows the prospect of extensive application.

关 键 词：经皮椎体成形术 椎体血管瘤 疼痛 

分 类 号：R651.2[医药卫生—外科学]