胸腰段椎体内血管分布与安全区内穿刺减少骨水泥的渗漏

背景：研究发现骨水泥渗漏大多与椎体成形治疗椎体压缩性骨折中椎体静脉回流相关。目的：分析胸腰段椎体血管分布规律,为施行椎体成形治疗时预防骨水泥渗漏提供理论依据。方法：选择100例胸腰段压缩性骨折患者,其中T11椎体骨折组30例,T12椎体骨折组17例,L1椎体骨折组25例,L2椎体骨折组28例,术前CT检查观察及测量椎体血管沟角度分布、安全区位置、血管沟所处于椎体内的位置。结果与结论：各组椎体血管沟角度分布差异无显著性意义,表明椎体间血管沟走向及安全区范围相对恒定。各组椎体平均高度、椎弓根平均高度和血管沟平面占椎体的平均高度差异无显著性意义,表明椎弓根位于椎体的上2/3,血管沟所在位置相对恒定于椎弓根的上2/3。提示胸腰段椎体都有相对恒定的安全区范围,椎体成形治疗时改善穿刺角度且穿刺至安全区可减少骨水泥渗漏。

Effects of vascular distribution in the thoracolumbar vertebral body and puncture in the safe zone on bone cement leakage

BACKGROUND： According to the research, bone cement leakage has been mostly connected with vertebral venous return in the vertebroplasty treatment for vertebral compression fractures.OBJECTIVE： To analyze the vascular distribution of the thoracolumbar vertebral body, providing the theoretical basis for the prevention of bone cement leakage during the implementation of vertebroplasty.METHODS： There were 100 vertebral compression fracture patients, 30 of whom with T11 vertebra fracture,17 with T12 vertebra fracture, 25 with L1 vertebra fracture, and 28 with L2 vertebra fracture. They were examined with CT before operation to detect the distribution of venous grooves, the position of safe zone and venous grooves in the vertebra.RESULTS AND CONCLUSION： There was no significant difference in the distribution of venous grooves of the four groups. The data indicated that the course of venous grooves and the scope of safe zone among the vertebral body remained relatively constant. No statistical difference was noted in the average height of vertebra, vertebral pedicle or venous grooves plane in the vertebra, giving evidence that vertebral pedicle lies in the top 2/3 of the vertebra and venous grooves lies in the top 2/3 of the vertebral pedicle. There were constant safe zones in the thoracolumbar vertebral body. Improving the angle of puncture during the implementation of vertebroplasty contributes to the decrease of bone cement leakage.