经单侧椎弓根灌注固化磷酸钙骨水泥和聚甲基丙烯酸甲酯椎体成形的实验效果比较

目的比较经单侧椎弓根灌注自固化磷酸钙骨水泥（autosetting calcium phosphate cement,ACPC）和聚甲基丙烯酸甲酯（polymethylmethacrylate,PMMA）椎体成形的效果.方法用离体连续三节胸腰椎标本共10个,分别测定中间椎体和相邻椎间盘非破坏性载荷下标本运动时的应力、应变和刚度值.造成中间椎体压缩骨折的同时测定其极限载荷和刚度值.然后标本随机分成2组,分别经单侧椎弓根灌注3 mL ACPC和PMMA椎体成形后再同前测试.结果椎体成形术后,两组中间椎体扭转刚度较初始皆有下降,两组之间有显著性差异;两组中间椎体抗压极限载荷较初始都有显著性提高;ACPC组椎体极限刚度不能恢复;PMMA组相邻椎间盘应力显著增加21%左右.结论经单侧椎弓根灌注ACPC和PMMA都能较好恢复椎体的生物力学性能,但在扭转刚度和极限刚度的恢复上灌注PMMA稍好一些.灌注ACPC椎体成形后相邻椎间盘不出现高应力现象和载荷传递异常效应,有望降低相邻椎体继发骨折的发生率.     

单侧入路的椎体成形术治疗老年椎体压缩性骨折

目的探讨单侧椎弓根入路经皮椎体成形术治疗老年椎体压缩性骨折的疗效与安全性。方法回顾性分析了36倒老年椎体压缩性骨折的椎体成形术治疗，其中20例为单侧椎弓根入路，16例双侧椎弓根入路。结果两组老年椎体压缩性骨折的经皮椎体成形术均获得成功，无手术并发症，两组疼痛评分和自理生活能力评分术后均显著下降（P〈0．01）；两组间完全缓解率及总显效率比较差异无显著性（P〉0．05），双侧组手术80min，单侧组手术45min，两组间手术时间差异有显著性（P〈0．01）。结论术前影像学资料的分析对单侧入路选择非常重要，单侧椎弓根入路的经皮椎体成形术治疗老年椎体压缩性骨折是安全可行的。     

经单、双侧椎弓根入路椎体成形术渗漏比较研究

目的：对离体椎体经单侧和双侧椎弓根入路的两种椎体成形方法引发的椎体外骨水泥渗漏进行比较研究。方法：采集尸体的腰椎（L1-L5）共40个,在前屈压缩载荷下造成椎体骨折。然后随机分成两组,A组经单侧椎弓根注入椎体4ml PMMA;B组经双侧椎弓根灌注4ml PMMA（每侧2ml）。注射过程中观察有无骨水泥渗漏发生,按部位计数渗漏的椎体并计算渗漏率。结果：A组有11个椎体发生渗漏,经终板渗漏11个、椎体前侧缘4个、椎体后缘3个、穿刺道渗漏6个、混合渗漏6个（2例椎体前侧缘＋穿刺通道,4例终板＋椎体前侧缘）,渗漏率为41.25%。B组有12个椎体发生渗漏,经终板3个、椎体前侧缘4个、椎体后缘3个、经穿刺道渗漏12个、混合渗漏4个（2例终板＋穿刺道,2例椎体前侧缘＋穿刺通道）,渗漏率为27.5%。两组渗漏率差异有统计学意义。结论：双侧椎弓根入路椎体成形骨水泥渗漏少于单侧,有统计学意义。     

单侧椎弓根旁入路与双侧椎弓根入路行椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的效果比较

目的比较单侧椎弓根旁入路与双侧椎弓根入路治疗骨质疏松性椎体压缩性骨折（OVCF）的临床效果,为该类疾病的治疗提供临床参考。方法选择徐州市中心医院2008年3月．2011年3月收治的OVCF患者98例。根据术式不同分为单侧椎弓根旁入路组及双侧椎弓根入路组。单侧椎弓根旁入路组（46例78椎）使用单侧椎弓根旁入路行椎体后凸成形术（PKP）治疗,双侧椎弓根人路组（52例74椎）使用双侧椎弓根入路行PKP治疗。对两组患者的VAS评分变化、手术时间、住院时间、伤椎体高度改变等指标进行评价。结果①单侧椎弓根旁入路组手术时间[（28±8）min]明显短于双侧椎弓根旁入路组[（37±12）min],差异有统计学意义（P〈0．05）;骨水泥灌注量、住院时间两组比较差异无统计学意义（P〉0．05）。②两组患者术后48h和3个月时VAS评分低于术前。前部及中部伤椎高度均高于术前,差异均有统计学意义（P〈0．05）。两组术后48h时VAS评分、前部及中部伤椎高度比较,差异无统计学意义（t=0．914、1．103、0．697,P〉0．05）;两组术后3个月时VAS评分、前部及中部伤椎高度比较,差异无统计学意义（t=0．713、0．932、0．715,P〉0．05）。结论单侧椎弓根旁入路与双侧椎弓根入路行PKP均可以改善运动功能和减轻疼痛,可安全增加椎体高度,且单侧椎弓根旁入路PKP术具有手术时间短的优点。     

骨水泥和骨泰应用于椎体后凸成形术的实验研究

目的探讨骨水泥（PMMA）和注射性骨泰（CPC）在椎体后凸成术中对不同骨密度椎体的生物力学恢复情况。方法选60个椎体，按骨密度分正常对照组、轻中度和重度骨质疏松组，即A、B、C组。测高后轴向加载，压缩椎体高度25％，得出初始压缩强度和刚度。行椎体后凸成形术后（记球囊扩张体积），随机注入PMMA或CPC，观察外渗情况及注入量。同术前测高压缩，确定术后压缩强度和刚度。结果A组CPC和PMMA材料未能恢复椎体的初始压缩强度和刚度（P〈0．05）；B组中均恢复，而C组中刚度均恢复（P〉0．05）。所有标本未发现骨水泥外渗，术后椎体高度恢复CPC组为95．3％；PMMA组为95．2％。结论CPC可作为PKP术中PMMA的替换材料，尤其是在年青患者中，但需临床和实验进一步论证。     

不同剂量自固化磷酸钙人工骨在椎体成形术中的效果比较

目的　探讨自固化磷酸钙人工骨 (autosettingcalciumphosphatecement,ACPC)椎体成形术对椎体生物力学性能的影响。方法　自 8具尸体脊柱标本上取胸腰段椎体共 2 4节 ,在前屈压缩下造成骨折 ,随机分成 4组 ,分别经双侧椎弓根注入椎体 2、4、6和 8mLACPC ,再行前屈压缩。测定初始和术后椎体抗压强度和刚度 ,观察实验过程中椎体高度变化。结果　经双侧椎弓根注入椎体 2mLACPC就能显著性增强椎体抗压强度 ,同时刚度无明显变化。实验虽能在一定程度上恢复椎体高度 ,但从临床角度看无重要意义。结论　合理选择灌注剂量既能显著恢复椎体的生物力学性能 ,又可以减少灌注剂渗漏。椎体成形术对压缩骨折后的椎体高度恢复作用不大     

单侧与双侧椎弓根入路椎体成形术治疗骨质疏松性椎体压缩骨折

目的：对比研究经皮椎体成形术采用单侧和双侧椎弓根入路治疗老年新鲜骨质疏松性椎体压缩骨折（OVCFs）的临床效果.方法：应用椎体后凸成形术治疗胸腰椎椎体压缩性骨折48例（56椎）,包括单侧椎弓根入路组27例（33椎）和双侧椎弓根入路组21例（23椎）.结果：所有患者随访8～24个月,平均14个月.比较两组术前与术后VAS评分、椎体前缘高度的恢复情况,术前、术后差异有统计学意义（P＜0.05）,但单侧及双侧入路组两组组间比较差异无统计学意义（P＞0.05）.单侧入路组手术时间、“C”臂照射时间及骨水泥用量均显著小于双侧入路组（P＜0.05）.结论：采用单侧及双侧入路进行椎体成形术治疗骨质疏松性胸腰椎压缩骨折的临床效果没有差异,但单侧入路具有手术时间短、“C”臂照射时间短、骨水泥用量小等优点.     

经单侧或双侧椎弓根途径行椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折对比研究

目的 探究与分析经单侧或双侧椎弓根途径行椎体后凸成形术（Posterior Kinkoplasty, PKP）治疗老年骨质疏松性椎体压缩骨折的效果。方法 随机选取2019年4月—2022年1月福州市第一医院收治的老年骨质疏松性椎体压缩骨折患者90例,按照不同手术治疗方法分为单侧组（n=48）及双侧组（n=42）,单侧组给予单侧椎弓根途径行椎体后凸成形术治疗,双侧组给予双侧椎弓根途径行椎体后凸成形术治疗。对比两组患者的围术期指标、手术治疗前后的椎体前缘高度压缩率、椎体前缘高度、椎体中间高度、伤椎Cobb角、视觉模拟评分（VAS）及ODI指数,同时观察两组患者并发症。结果 单侧组手术时间、术中透视时间、骨水泥注入量、住院时间比双侧组少,差异有统计学意义（P<0.05）。治疗后,两组患者椎体前缘高度压缩率、伤椎Cobb角小于治疗前,椎体前缘高度、椎体中间高度高于治疗前,差异有统计学意义（P<0.05）。治疗后,两组患者VAS评分、ODI指数低于治疗前,差异有统计学意义（P<0.05）;治疗后,两组VAS评分、ODI指数相比,差异无统计学意义（P>0.05）。治疗后,两...     

单侧椎弓根入路椎体成形术治疗老年人胸腰段爆裂性骨折

近年来,经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）用于治疗老年人胸腰段骨折技术得到不断改进并取得满意疗效。2009-10/2012-04月,作者应用单侧椎弓根入路椎体成形术治疗15例（15个椎体）无神经症状的老年人胸腰段爆裂性骨折,观察到经单侧椎弓根穿刺法行PKP能够达到类似双侧椎弓根穿刺PKP的满意效果。     

枢椎交叉椎板螺钉新技术治疗寰枢椎不稳的生物力学比较

目的对枢椎交叉椎板螺钉治疗寰枢椎不稳这一新的内固定技术进行生物力学评估。方法成年国人甲醛固定的枕颈（C0～C4）标本10具，对寰枢椎不稳模型分别行Gallie法内固定、双侧Magerl法内固定、C1椎弓根-C2交叉椎板螺钉内固定，进行寰枢关节的强度、刚度测量，分析寰枢椎的载荷-位移、应力-应变、扭矩-扭角关系和扭转刚度指标。结果Gallie法内固定明显增强了寰枢椎不稳模型的稳定性，但其固定强度明显小于Magerl法和C1椎弓根-C2交叉椎板螺钉内固定（P〈0．05），C1椎弓根-C2交叉椎板螺钉内固定强度大于双侧Magerl法，但没有统计学意义（P〉0．05）。结论C1椎弓根-C2交叉椎板螺钉内固定能为失稳的寰枢关节提供坚强的生物力学环境，枢椎交叉椎板螺钉技术具有良好的临床应用前景。     

单、双侧椎弓根入路经皮椎体后凸成形术临床回顾的比较研究

目的比较经单、双侧椎弓根入路灌注骨水泥经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF),回顾性评价两种手术入路的临床效果。方法选取2008年10月至2011年12月首都医科大学良乡教学医院骨科收治的OVCF患者112例作为研究对象,所有患者均接受PKP治疗,其中经单侧椎弓根入路组65例68个椎体,经双侧椎弓根入路组47例59个椎体。比较两组患者的术前及术后1 d视觉模拟评分(VAS),伤椎高度,后凸Cobb's角、手术时间、骨水泥注入量、伤椎高度丢失,骨水泥渗漏及随访期间邻近椎体骨折情况。结果两组患者在手术时间(t=-11.905,P=0.002)、骨水泥注入量(t=-2.810,P=0.007)、骨水泥渗漏(χ2=5.477,P=0.019)及相邻椎体骨折(χ2=4.394,P=0.036)等方面比较差异有统计学意义;单侧椎弓根入路组患者术后即刻椎体高度增加显著低于双侧椎弓根入路组(t=-2.978,P=0.004),术后12个月椎体高度丢失显著高于双侧椎弓根入路组(t=11.511,P=0.001);两组椎体压缩骨折患者的后凸Cobb's角在不同时点间、组间以及组间·不同时点间比较差异均无统计学意义(F=0.063,3.765,0.072,P>0.05);VAS在不同时点间、组间以及组间·不同时点间比较,差异均有统计学意义(F=5.783,106.558,19.101,P<0.05)。结论两种骨水泥灌注入路都能较好的恢复椎体高度,并达到理想的止痛效果,双侧椎弓根入路PKP远期效果较单侧入路好。     

国产新型骨材料填充器行经皮椎体成形术的实验观察

目的 探讨应用不同层数设计的新型网袋状骨材料填充器行椎体成形术对椎体生物力学性能及骨水泥在椎体内分布的影响.方法 自4具新鲜冰冻尸体脊柱标本上28个胸腰段椎体,随机分成4组,测量各标本的骨密度、前缘和中线左右侧高度以及原始刚度和强度后,建立压缩骨折模型并测量骨折后标本的高度和刚度.分别应用单层和双侧设计的网袋状骨材料填充器经单侧或双侧椎弓根注射PMMA后再次测量椎体的高度、强度和刚度.观察填充器在椎体内的膨胀情况及PMMA在椎体内的分布情况.结果 各组椎体成形术后刚度和高度较骨折后水平均有恢复,双侧穿刺组刚度明显优于单侧穿刺组.术后强度均较原始值大,但各组术后强度、高度比较差异无统计学意义.轴位透视下见双层骨材料填充器组PMMA在椎体内呈椭圆形或长椭圆形分布,单层组分布不规则.横断标本后,见双层填充器能在椎体内良好膨胀,包裹绝大部分PMMA,仅少量PMMA渗漏到网层周围.单层填充器在椎体内膨胀欠佳,大量骨水泥渗漏到网层外.结论 虽然两种骨材料填充器均能较好恢复骨折椎体的力学性能和高度.但双层设计的骨材料填充器在椎体标本内能更好的包裹绝大部分PMMA,防止骨水泥渗漏,具有更好的临床应用前景.

Abstract：

Objective To investigate vertebral augmentation with a novel reticulate bone filling container system by polymethyl methacrylate (PMMA) injection in cadaveric simulated vertebral compressive fracture and explore the effect of reticulate bone filling container on cement distribution controlling within vertebral body and the restoration of biomechanical properties after augmentation. Methods A total of 28 freshly frozen human vertebrae specimens were randomly divided into 4 groups. After the measurements of bone mineral density (BMD) and vertebral height, each vertebra received an axle load by a MTS (material testing system) machine to test the initial strength and stiffness. Subsequently a simultaneous compressive fracture model was created to measure the stiffness and height of fractured vertebrae. Then the augmentation procedure was performed. Afterward the biomechanical properties and the vertebral height were similarly measured as pre-operatively. The expansion of bone filling container and the distribution of cement within vertebral body were morphologically observed by crossing the specimens in sagittal midline and also intergraded with the radiographic results. Results Stiffness was significantly restored comparing with that of fractured level (P ＜ 0. 05). And the bipedicular groups had better restoration results than the unipedicular groups. The strength and height of specimens significantly increased after the augmentation procedure but without difference among groups. In axial radiographic view, the distribution of cement in vertebral body was oval or long oval-shaped in double-layer bone filling container groups while it was irregular in single-layer groups. After crossing, the double-layer version expanded well in vertebral body and could enwrap most of injected cement. There was only a little leakage near the vessel layer. But the single-layer version had a poor expansion and a large amount of cement leakage. Conclusion This novel reticulate bone void fillingcontainer system with different layers may restore both the biomechanical properties and the height of fractured vertebrae. But, with the benefit of reducing cement leakage, a double-layer design can enwrap most of injected PMMA and has a brighter prospect of clinical application.     

胸腰椎压缩性骨折模型中geneX骨水泥椎体成形术的生物力学评价

目的评估geneX骨水泥用于强化骨质疏松椎体的生物力学性能。方法对30个新鲜小牛胸腰椎椎体标本(T9-L4)通过注射泵灌注稀盐酸脱钙建立骨质疏松椎体模型。随机分为3组,每组10例。制成压缩性骨折模型后,3组分别实施geneX骨水泥、硫酸钙骨水泥(CSC)、聚甲基丙烯酸甲酯骨水泥(PMMA)椎体成形术,记录骨水泥完本填充时的骨水泥注射量,测试标本的强度和刚度,记录各组的强度和刚度并进行比较。结果 30个小牛胸腰椎体初始骨密度为(1.425±0.072)g/cm2,脱钙后骨密度为(1.074±0.065)g/cm2,脱钙后骨密度明显低于脱钙前骨密度(P<0.05)。geneX组、CSC组、PMMA组注射量分别(4.3±0.8)、(4.2±0.7)和(3.8±0.4)ml,3组之间无显著性差异(P>0.05)。geneX组、CSC组、PMMA组强度分别(1198±529)、(1212±430)和(1672±704)N,geneX组、CSC组显著低于PMMA组强度(P<0.05),3组均明显高于椎体初始强度(P<0.05)。geneX组、CSC组、PMMA组刚度分别为(233±130)、(242±191)与(323±145)N/mm,3组间无显著性差异(P>0.05),3组刚度均低于椎体初始刚度,但统计学无明显差异(P>0.05)。结论 geneX骨水泥椎体成形术用于骨质疏松压缩性骨折能满足对椎体填充材料的生物力学要求。     

骨静脉造影在椎体成形术治疗症状性椎体血管瘤中的价值探讨

目的 评价经皮椎体成形术(PVP)治疗症状性椎体血管瘤的安全性、临床疗效,探讨术中先行椎体骨静脉造影是否能降低骨水泥(PMMA)渗漏的发生及提高临床疗效.方法 2001年3月至2010年1月,南京东南大学附属中大医院放射科治疗椎体血管瘤患者45例共53节,均有不同程度胸背部或腰背部疼痛,其中马尾受压瘫痪1例,椎体压缩骨折3例.分为两组:A组为先行椎体骨静脉造影后再注入PMMA共23例27节椎体;B组为直接注入PMMA 22例26节.PVP后1～3 dCT复查观察PMMA分布及有无椎体周围渗漏.比较两组疗效、PMMA渗漏情况、注入量、手术成本及术中X线辐射时间.结果 PVP技术成功率100%,PMMA平均注入量3.96 ml.随访6个月～5年,除A组初期1例无效外,余44例术后1周疼痛均有改善,术后1、3个月疼痛进一步减轻,6个月及1年疗效均保持稳定,CR、PR和NR分别为84.5%、13.3%、2.2%.6个月时,A组有效率为95.7%,B组为100%,两组比较差异无统计学意义(P=0.323).CT证实PMMA椎旁渗漏共有8节,均无临床症状,其中A组有6节,B组有2节(P=0.140).A组平均注入PMMA量为3.70 ml,B组为4.23 ml(P=0.157);A组平均手术费用为7.24千元/节,B组为5.84千元/节(P=0.000),B组比A组节省约1.4千元/节;A组平均X线照射时间为13.28 min,B组为8.78 min(P=0.000),B组比A组减少约4.5 min.结论 PVP为椎体血管瘤安全、有效的治疗方法;技术要领为经血管瘤侧椎弓根穿刺,PMMA应完全充填血管瘤并部分超出其边缘;椎体骨静脉造影不能提高PVP疗效和安全性,相反增加了手术成本和X线照射时间.     

PVP治疗老年急性椎体骨折的临床应用

目的：探讨经皮椎体成形术（PVP）对治疗老年急性椎体骨折的临床应用价值。方法：36例老年急性压缩性和粉碎性椎体骨折的患者,骨折的部位为椎体的前部或／和中部,患者均不伴有神经功能障碍。选择椎体骨折相对严重的一侧注入骨水泥,骨水泥的剂量控制在2～6ml范围内。分别在术前、术后48h记录疼痛分数和功能水平（巴塞尔指数）以评价治疗效果。结果：36例急性椎体骨折的患者,43个骨折的椎体进行PVP治疗。术前的疼痛分数为（17．99±1．45）,术后48h为（6．04±1．32）,两者比较差异有统计学意义（P〈0．001）。巴塞尔指数术前为（54．07±16．56）,术后48h为（88．12±15．98）,两者比较差异有统计学意义（P〈0．001）。其中9例在骨水泥注射过程中进入椎体的两侧或前方,1例进入椎间盘和椎管,2例进入静脉,1例进入肺动脉,但患者均无临床症状。结论：经皮椎体成形术是一种治疗老年急性椎体骨折的微创、安全、有效的方法,能迅速缓解患者的临床症状和体征。     

Percutaneous vertebroplasty using instruments and drugs made in China for vertebral metastases

Objectives To evaluate the effect of percutaneous vertebroplasty on vertebral tumor metastasis using instruments and drugs made in China and to explore the technique of percutaneous vertebroplasty.Methods Thirty-two patients with vertebral metastasis were treated with percutaneous vertebroplasty with instruments and drugs made in China. Anterolateral approach for cervical vertebrae and transpedicular approach for thoracic and lumbar vertebrae were used. The volume of disease focus and the amount of polymethy methacrylate (PMMA) injected were calculated with formula V =4/3π(D/2) …^3 preoperatively. PMMA with contrast was mixed according to the ratio of powder/liquid/contrast of 3:2:1. The procedures were monitored under fluoroscopy. PMMA was injected in the polymerization time. CT scanning was performed before and after the operation.Results The percentage of lesion PMMA fill was more than 50% as demonstrated by CT. Clinical data were obtained from the cases followed up for 7 - 12 months, and the rate of pain relief was 90. 6% (29/32) at one week, 71.8% (23/32)at six months, and 58.6%(17/29)at 12 months after operation. There were no cases of PMMA leakage that affected clinical performance.Conclusions Percutaneous vertebroplasty for vertebral tumor metastasis using instruments and drugs made in China was effective. It is important to prevent paravertebral leaks of PMMA and to ensure that PMMA is injected within the polymerization time.     

高龄胸腰椎骨质疏松压缩性骨折经皮椎体成形术治疗效果分析

目的探讨经皮椎体成形术治疗高龄胸腰椎骨质疏松压缩性骨折的效果。方法选择65例胸腰椎骨质疏松压缩性骨折高龄患者,按手术编号随机分为观察组与对照组,观察组33例应用经皮椎体成形术治疗,对照组32例采用非手术疗法,治疗3个月后,比较两组患者疼痛视觉模拟VAS评分,伤椎前后缘高度恢复情况、Cobb’s角矫正情况,并发症发生情况。结果治疗后两组VAS评分均较前降低,且观察组较对照组更明显,两组比较有统计学差异（P〈0.05）;治疗后观察组伤椎前后缘高度、Cobb’s角改善情况明显优于对照组,两组比较有统计学差异（P〈0.05）;而并发症发生情况两组比较无统计学差异（P〉0.05）。结论经皮椎体成形术治疗高龄胸腰椎骨质疏松压缩性骨折效果肯定。     

PVP联合动脉栓塞化疗术治疗复杂性脊柱转移肿瘤

目的 探讨经皮椎体成形术(PVP)联合动脉栓塞化疗术治疗复杂性脊柱转移肿瘤的疗效和安全性.方法 收集2003年3月至2009年12月东南大学附属中大医院内科放化疗后疼痛无缓解的复杂性脊椎转移肿瘤患者49例共72节,背部疼痛评价多为重度,其中合并下肢放射痛17例、双下肢不同程度瘫痪6例.选择性椎体动脉栓塞化疗术后6 d内行PVP,PVP后3 d内CT复查观察PMMA分布及渗漏情况,采用VAS评分及WHO疼痛标准评价疗效,定期随访.结果 双侧椎体动脉选择性插管有44例65节,仅选择人单侧有5例7节.用碘化油1～2 ml+明胶海绵颗粒栓塞29节,单纯用明胶海绵颗粒栓塞41节,单纯灌注化疗2节.平均注入PMMA胸椎4.23 ml,腰椎5.39 ml.联合治疗后3个月CR 21例(42.9%)、PR 22例(44.9%)、MR及NR6例(12.2%),总有效率87.8%.CT证实12例椎体周围PMMA渗漏16节,均无临床症状,无其他严重并发症发生.结论 椎体动脉栓塞化疗和PVP都是脊椎转移性肿瘤的有效治疗手段,二者联合可显著提高椎体合并附件及椎旁转移肿瘤患者的疗效.

Abstract：

Objective To evaluate the efficacy and safety of combining transarterial chemoembolization and percutaneous vertebroplasty (PVP) in the treatment of vertebral and paravertebral metastatic tumors. Methods A retrospective review was conducted in 49 patients with severer painful tumor metastasis in 72 vertebrae and paravertebral tissue who had failed noninvasive treatment at our institution from March 2003 to December 2009. Among them, there were intractable radicular pain ( n = 17) and slight or no motor and sensory function ( n = 6). All patients under transarterial chemoembolization were followed within 6 days by PVP. Computed tomography (CT) was performed within 3 days after PVP to observe the distribution of PMMA ( para-methoxymethamphetamine ) in vertebrae and whether or not there was any leakage. The efficacy was assessed by the change of pain level after combined treatment. Results Bilateral vertebral arteries were selected in 44 cases with 65 vertebrae. And only unilateral vertebral artery was selected in 5 cases with 7 vertebrae. Except for 2 vertebrae with simple artery infusion, 29 vertebrae were embolized by 1-2 ml of lipiodolization and gelfoam particles and 41 vertebrae by gelatine particles. And an average volume of 4. 23 ml and 5.39 ml was injected in each thoracic and lumbar vertebra respectively. The rate of efficacy was at 87. 8% within 3 months after combined therapy. There were CR( complete response)21cases (42. 9% ), PR (partial response) 22 cases(44.9%)and MR/NR (minimal/no response) 6 cases (12. 2% ). No serious complication related to the technique occurred. Only 12 cases with asympotomatic PMMA leakage around 16 vertebrae were demonstrated on post-operative CT. Conclusion Transarterial chemoembolization plus PVP is an effective and safe procedure in the treatment of severe painful vertebral and paravertebral metastatic tumors.     

椎体成形术后再骨折相关因素分析

目的:探究椎体成形术后再骨折的相关因素.方法:选取在2017年1月-2019年12月我院收治的97例骨质疏松性椎体压缩性骨折患者,所有患者均进行椎体成形术治疗.其中有27例出现再发骨折情况(观察组),70例没有出现再发骨折情况(对照组).对所有患者的临床病历资料进行回顾性分析,并对患者的性别、年龄、终末随访定量CT值、...