经皮椎体成形术治疗椎体压缩性骨折与血管瘤

目的总结经皮椎体成形术治疗疼痛性椎体压缩性骨折和症状性椎体血管瘤的临床经验,评估其治疗疗效。方法回顾性分析35例疼痛性椎体压缩性骨折和7例症状性椎体血管瘤的椎体成形术治疗,其中腰椎30例,胸椎10例,颈椎2例,40例采用单侧或双侧椎弓根入路,2例颈椎血管瘤采用颈椎前外侧入路。注射13%～20%的骨水泥,使骨水泥在椎体内分布、铸形。结果42例治疗都获得成功,注射骨水泥0.5～7mL。42例随访3～15个月,33例患者术后3个月疼痛完全缓解,7例明显缓解,2例有所缓解。42例疼痛评分和自理生活能力评分术后均显著下降(P<0.01)。无复发迹象。结论采用经皮椎体成形术治疗疼痛性椎体压缩性骨折及症状性椎体血管瘤是一种微创、安全、有效的治疗手段。

Treatment of painful vertebral compressive fractures and hemangiomas with percutaneous vertebroplasty.

Objective To summarize the clinical experiences of painful compressive fractures and hemangiomas of vertebral bodies with percutaneous vertebroplasty and to evaluate treatment efficiency of vertebroplasty. Methods Retrospectively analyze the treatment of 35 cases of painful compressive fractures of vertebral bodies and 7 cases of vertebral hemangiomas with vertebroplasty. Among them 30 cases were involved lumbar vertebra, 10 cases were involved thorax vertebra, 2 cases were involved cervical vertebra. Unipedicular or bipedicular approaches were used in 40 cases, and in 2 cases of cervical hemangioma, the cervical anterior-lateral approach was adopted. 13-20% of bone cement was mixed and injected into the vertebral lesions and made to distribute and cast in the lesions.Results Good results were got in all the 42 cases, after 0.5-7 mL of cement was injected into the lesions. The complete relief clinical experiences was got in 33 cases and sub-complete relief was achieved in 7 cases and medial relief was got in two cases.With three to fifteen months of postoperative follow-up,6-point Bahavioral Rating Scale and Activity of Daily Living (ADL) declined significantly after the treatment(P<0.01),no recurrences was found in follow-up (3-15 months).Conclusions The treatment of painful compressive fractures and hemangiomas of vertebral bodies with percutaneous vertebroplasty was mini-invasive, safe, and effective.