经皮椎体成形术治疗症状性脊椎血管瘤

目的 探讨经皮椎体成形术(percutanous vertebroplasty，PVP)治疗症状性脊椎血管瘤的临床效果。方法 共11例患者，男2例，女9例；年龄35-77岁，平均54.3岁；均有背部疼痛等症状,其中2例有神经根刺激症状；病变部位：胸椎11处，腰椎3处；在DSA或CT监测下对16个稚体(包括2处骨质疏松压缩骨折)行PVP。术后行CT检查。随访3-34个月（平均15.2个月)。结果 11例PVP后均未出现肺栓塞、神经损伤等并发症，术后CT检查示均无推管内或椎间孔渗漏。仅2例2椎存在椎旁少量渗漏，1椎系穿刺针穿破椎体前缘所致，1椎系沿稚旁静脉充盈所致，均未引起临床症状。术后患者背部疼痛均明显减轻或消失，神经根刺激症状消失。首例患者术后疼痛-过性加重，3d内好转、疼痛减轻，考虑与局部炎症有关。术后住院1-4d(平均15d)。随访时症状缓解或消失，与术后相比无明显变化。结论 PVP为症状性脊椎血管瘤提供了一种较好的微创治疗方法。

A preliminary clinical application of percutaneous vertebroplasty (PVP) for symptomatic vertebral hemangioma

Objective To investigate the clinical results of percutaneous vertebroplasty(PVP) for symptomatic vertebral hemangioma. Methods Eleven patients(2 males and 9 females) suffered from symptomatic vertebral hemangioma(11 thoracic segment levels and 3 lumbar segment levels) were treated with PVP under DSA or CT guidance. The main goal of this procedure was to relieve hemangioma related pain. All patients were examined with CT scan after intervention and were followed up from 3 to 34 months (average, 15.2 months). Results The procedure was technically successful in all patients, with an average injection amount of 6.3 ml cement per vertebral body. No clinically significant complications were found. There was no epidural leakage, and the 2 paravertebral leakages detected with CT had no clinical importance. Partial or complete pain relief was achieved in all patients associated with improved mobility, and 1 patient experienced transitory worsening of pain followed by significant pain relief. Patients were discharged in 1-4 days (average, 1.5 days) after the procedure. Pain relief was sustained in all patients at the last following-up. Conclusion PVP is a valuable minimal invasive alternative procedure in treatment of symptomatic vertebral hemangioma and provides satisfactory pain relief with less complications.