X线及CT引导下经皮椎体成形术治疗胸腰椎压缩性骨折

目的:探讨X光机透视及CT监视下行经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗胸腰椎压缩性骨折的临床效果。方法:在X光机及CT监视下行经皮单侧椎弓根入路向椎体内穿针注入骨水泥,手术前后疼痛应用视觉模拟分级法(visual analog scale,VAS)评分。结果:66例82个椎体PVP均获成功,手术时间每个椎体平均30 min,术后VAS(2.8±0.15)分。56例术后随访3~35个月,胸腰背疼痛无再发及加重,椎体高度无明显变化,相邻椎体未见骨折。结论:X光机透视监视及CT引导下经皮PVP定位准确,操作时间短,能迅速缓解疼痛,恢复椎体高度,增加脊柱稳定性,对治疗胸腰椎压缩性骨折效果较好。

Treatment of thoracolumbar compression fracture by computer tomography andC-arm X-ray machine guided percutaneous vertebroplasty

Objective： To evaluate the computed tomography（CT） and C-arm X-ray guided percutaneous vertebroplasty（PVP）in treatment of thoracolumbar fractures. Methods：Sixty-six cases of thoracolumbar fractures underwent percutaneous vertebroplasty with the guidance of CT and C-arm X-ray machine. The visual analog scale （VAS） was used to assess the effects before and after PVP. Results：The PVP was performed successfully in all the 66 cases（ a total of 82 vertebrae）. The mean operation time was 30 min per vertebra. The VAS score at 2 weeks after operation（ 2.8 ~ 0.15 ）. Fifty-six patients were followed up for 3 - 35 months. No recurrence or exacerbation of chest and back pain was noted. The height of the veterbral body had no change, and there was no fracture in the adjacent veterbral bodies. Conclusions： Percutaneous vertebroplasty under the guidance of computer tomography and C-arm X-ray machine is safe and effective for treatment of thoracolumbar fractures.