摘要
目的探讨CT或C型臂引导下经皮椎体成形术治疗骨质疏松椎体压缩性骨折的早期临床效果及骨水泥渗漏的预防。方法2001年8月～2006年4月，55例（59个椎体）骨质疏松椎体压缩性骨折患者在CT或C型臂引导下，经皮椎弓根向椎体内穿针并注入聚甲基丙烯酸甲酯（PMMA）。术后CT和X线片观察骨水泥的分布和渗漏情况，并进行临床疗效评价，观察有无并发症发生。结果患者术后12h～3d疼痛明显减轻或消失。1例患者造影剂渗漏广泛而放弃注射PMMA，其余54例患者平均每个椎体注入骨水泥4．5mL，影像学检查骨水泥充满良好，骨折复位满意。55例骨质疏松症患者中39例完全缓解，12例部分缓解，4例轻度缓解。2个椎体出现骨水泥渗漏，1个椎体有椎管内少量渗漏，1个椎体出现椎旁渗漏，均未引起临床症状。对48例患者进行8～60个月（平均33.1个月）随访，治疗部位疼痛无明显加重，椎体形态无改变。结论经皮椎体成形术是治疗骨质疏松椎体压缩性骨折安全有效的微创技术。限量骨水泥注射法是预防骨水泥渗漏的关键。
Objective To discuss the short-term effect and complication prevention of the percutaneous vertebroplasty guided by CT or fluoroscopy for osteoporotic vertebral body compression fractures. Methods Fifty-five patients with painful compression fracture of osteoporotic vertebral body undergone percutaneous vertebroplasty. Polymethylmethacrylate（PMMA） was injected into the 59 vertebral bodies through the pedicle under CT or only C-arm fluoroscopy monitoring. After the procedure, CT scanning was carried out to observe PMMA distribution in the vertebra and leakage of PMMA. The clinical efficacy was evaluated and the complication was observed. Results Forty-eight patients were followed up for 8 to 60 months. Pain was relieved 12 hours to 3 days after treatment in all the patients. An average 4. 5 mL of PMMA was injected. Thirty-nine patients had complete pain relief, and 12 moderate relief. X-Ray and CT revealed PMMA leakage into the spinal canal in one case and around the vertebral body in the other. The leakage did not lead to any clinical symptoms. No deterioration of pain or deformity of vertebral body was found. No other complications occurred in the operation or after operation. Conclusions Percutaneous vertebroplasty is a safe, feasible and minimally invasive treatment for osteoporotic vertebral compressive fractures. The key point to prevent the main complication, the PMMA leakage, is an injection of well-suited volume.
出处
《中华创伤骨科杂志》
CAS
CSCD
2007年第7期612-615,共4页
Chinese Journal of Orthopaedic Trauma
基金
广州市医药卫生科技项目（200436）
关键词
脊柱骨折
骨质疏松
经皮椎体成形术
Spinal fracture
Osteoporosis
Percutaneous vertebroplasty
