摘要
目的分析经皮椎体成形术治疗症状性椎体血管瘤的远期疗效。方法17例患者19处椎体血管瘤,13处椎体无压缩骨折,6处椎体已发生压缩骨折。17例患者均诉不同程度胸背部或腰部疼痛,其中5例发生压缩骨折的患者还伴有不同程度的神经功能缺陷(4例)或脊髓受压症状(2例)。在DSA监测下行经皮椎体成形术(PVP)。术后随访6～32个月,平均(15.8±8.7)个月。结果19处血管瘤椎体PVP均获得成功,术中每个椎体注射PMMA2～6ml,4例发生椎旁渗漏,2例发生硬膜外渗漏,但未出现明显的临床症状,1例椎体其上椎间盘发生渗漏。短期随访显示17例患者胸背部或腰部疼痛均有不同程度缓解,2例神经根或脊髓受压患者症状消失,其余3例患者症状仍存在。长期随访示2例患者疼痛加剧,系邻近椎体骨质疏松性压缩骨折引起。结论PVP是治疗症状性椎体血管瘤的一种安全、有效、创伤小的方法,远期疗效可靠。
Objective To investigate the long term clinical results of symptomatic vertebral hemangiomas （SVHs）treated by percutaneous vertebroplasty. Methods A retrospective analysis of 17 cases withl9 symptomatic vertebral hemangiomas associated with chronic pain （all cases）or neurological deficit （4 cases）or spinal cord compression（2 cases）, were treated and followed up from 6 to 32 monthes, mean 15.8 ± 8.7months. There were 6 compressive fractures in the vertebral body with hemangioma before PVP, others were normal in morphology. All procedures were under DSA guidance. Results All procedures were technically successful in all cases with all vertebral bodies filled of PMMA through injection with amount from 1 ml to 6 ml per vertebral body. The outcomes showed 5 paravertebral leakages, 2 epidural leakages and 1 intradisc leakage during the procedure; but with no remarkable clinical symptoms. Pain relief was sustained in all patients at the follow-up. 2 patients with neurological deficit or spinal cord compression were cured. 2 patients had severe pain due to facture near the vertebral body because of osteoporosis after 6 months, which were performed wiht PVP. Conclusions Percutaneous vertebroplasty is a minimal invasive procedure providing an effective and safe technique in the treatment of symptomatic vertebral hemangiomas.
出处
《介入放射学杂志》
CSCD
2007年第10期676-680,共5页
Journal of Interventional Radiology
基金
上海市优秀青年医学人才基金项目资助(编号:沪卫人(2004)80号)
关键词
血管瘤
椎体
经皮椎体成形术
Hemangioma
Vertebral body
Percutaneous vertebroplasty
