期刊文献+

阶段注射法预防椎体成型术中骨水泥渗漏的实验研究 被引量:20

Staged-injection procedure to prevent cement leakage during vertebroplasty:an in vitro study
下载PDF
导出
摘要 目的通过离体实验评价两阶段注射法在椎体成型术中对骨水泥渗漏的预防作用。方法50个新鲜绵羊腰椎随机分成实验组及对照组。分别采用两阶段注射法及常规椎体成型方法,在X线透视引导下向椎体内注射总量为3mL的PMMA,模拟临床椎体成型术。实验组首先向椎体后部注射0.5mL的PMMA,待其固化后,再次向椎体内注射2.5mL的PMMA。对照组以常规方法向椎体内注射3mL的PMMA。通过X线及肉眼直视,统计两组骨水泥渗漏的发生率。结果对照组有8例出现骨水泥向椎管内渗漏,而实验组中仅2例,显著低于对照组(P=0.032)。尽管实验组骨水泥总体渗漏发生率56%高于对照组44%,但无统计学差别。结论两阶段注射法可显著降低骨水泥向椎管内方向渗漏的发生率。 Objective To determine the preventable effect of a staged-injection procedure in cement leakage during vertebroplasty. Methods 50 vertebral bodies (L1-L5) were harvested from each of 10 osteoporotic sheep (3± 1 years) , screened for bone density and disarticulated. PMMA was injected into vertebral bodies by the two-stage injection procedure ( group A) and the conventional injection procedure ( group B). In group A, 0.5 mL cement was injected at first stage. 15 minutes later, after the cement solidified, another 2.5 mL cement was injected into the center part of the vertebral bodies through transpedieular approach. In group B, vertebroplasty was performed through the transpcdicular approach as usual. When the tip of the needle reached aim area of vertebral bodies, 3.0 mL cement was injected one time. Cement leakage rates were recorded. Results The two-stage injection procedure resulted in a significant decrease in the epidural or canal leakage rate. Additionally, the paravertebral leakage rate was higher in two-stage injection procedure (56%) than in conventional injection procedure (44%). However, no significant difference was found for the total cement leakage rate in two groups. Conclusion Compared with conventional procedure, the two-stage injection procedure in vertebroplasty decreased incidence of epidural and canal leaks. The first-stage injecting PMMA can be a barrier to the epidural extravasation of cement during vertebroplasty.
出处 《中国骨质疏松杂志》 CAS CSCD 2010年第2期96-99,共4页 Chinese Journal of Osteoporosis
基金 国家863专项课题(2007AA02Z468)
关键词 椎体成型术 椎体压缩骨折 骨水泥渗漏 并发症 Vertebroplasty Osteoporotic compression fractures Cement leakage Complications
  • 相关文献

参考文献19

  • 1Barr JD, Barr MS, Lemley TJ, et al. Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine, 2000, 25: 9:23 -928.
  • 2Deramond H, Depriester C, Galibert P, et al. Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am, 1998, 36:533-535.
  • 3Watts NB, Harris ST, Genant HK. Treatment of painful osteoporotic vertebral fractures with percutaneous vertebroplasty or kyphoplasty. Osteoporos lnt, 2001, 12 : 429-437.
  • 4Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine, 2001, 26 : 1511-1515.
  • 5Shapiro S, Abel T, Purvines S. Surgical removal of cpidural and intradural polymethylmcthacrylate extravasation complicating percutaneous vertebroplasty for an osteoporotic lumbar compression fracture. Case report. J Neurosurg, 2003, 98: 90-92.
  • 6Yeom JS, Kim WJ, Choy WS, et al. Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fracture. J Bone Joint Surg Br, 2003, 85 : 83-89.
  • 7Groen RJ, du Toit DF, Phillips FM, et al. Anatomical and pathological considerations in percutaneous vertebroplasty and kyphoplasty : a reappraisal of the vertebral venous system. Spine, 2004, 29:1465-1471.
  • 8Galibert P, Deramond H. Note preliminaire sur le traitement des angiomes vertebraux par-vertebroplastie acrylique percutanec. Neurochirurgie, 1987, 33 (2) : 166-167.
  • 9Nakano M, Hirano N, Ishihara H, et al. Calcium phosphate cement leakage after pereutaneous vertcbroplasty for osteoporotic vertebral fractures: risk factor analysis for cement leakage.JNeurosurg Spine, 2005, 2: 27-33.
  • 10Ryu KS, Park CK, Kim MC, et al. Dose-dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures. J Neurosurg, 2002, 96: 56S-61S.

同被引文献157

引证文献20

二级引证文献199

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部