经皮椎体成形术治疗椎体血管瘤

目的总结经皮椎体成形术治疗椎体血管瘤的初步临床经验.方法7例椎体血管瘤患者,其中颈椎1例,胸椎3例,腰椎3例,6点疼痛评分为2.67±0.41,运动能力评分2.83±0.33.透视下定位有症状的椎体,采用局麻,俯卧位.6例胸椎、腰椎血管瘤患者采用单侧或双侧椎弓根入路,1例颈椎血管瘤采用颈椎前外侧入路,注射15%～20%的骨水泥,使骨水泥在椎体内分布、铸形.术后平卧6 h.术后1、3、9个月,采用临床症状检查、平片和CT的方法随访.结果7例手术都获得成功,注射骨水泥4～7 ml.5例患者术后疼痛完全缓解,2例明显缓解;2例同时具有神经根症状的患者,神经根症状缓解;术后疼痛评分(0.33±0.47)、运动功能评分(1.33±0.41)显著低于术前(P＜0.01).随访1～9个月,无复发.结论采用经皮椎体成形术治疗椎体血管瘤是一种创伤小、安全、有效的治疗手段.

Treatment of vertebral hemangioma with percutaneous vertebroplasty

OBJECTIVE: To investigate the efficacy of percutaneous vertebroplasty in the treatment of vertebral hemangioma. METHODS: Seven patients with vertebral hemangiomas were treated by percutaneous vertebroplasty, including one case of cervical, three cases of thoracic, and three cases of lumbar hemangiomas. The average score of the 6-point behavioral pain rating scale was 2.67 +/- 0.41, and the average score of ambulation was 2.83 +/- 0.33. Guilty vertebral bodies were orientated with fluoroscopy. The procedures were performed under local anesthesia. The image features were also analyzed. Unipedicular or bipedicular approaches were used in 6 cases of thoracic and lumbar hemangiomas. The cervical anterior-lateral approach was adopted in one case of cervical hemangioma. 4-7 ml of 15%-20% bone cement was mixed and injected into the vertebral body to form a cast in the lesions. Re-examination of clinical symptoms, plain film, and CT were made for 1, 3, and 9 months of post-procedure follow-up. RESULTS: Good results were achieved in all the seven cases. Pain was completely relieved in 5 cases and partially relieved in 2 cases. Symptom was also recovered in 2 patients with radiculopathy. No recurrence was found after 1-9 months of postoperative follow-up. CONCLUSION: Treatment of vertebral hemangioma with percutaneous vertebroplasty is safe and effective with minimal invasion.