椎体成形治疗中聚甲基丙烯酸甲酯骨水泥的应用

背景：经皮椎体成形治疗脊柱血管瘤可栓塞瘤体，增加椎体强度，并具有止痛作用。   目的：分析经皮椎体成形治疗症状性颈、胸、腰椎体血管瘤的临床效果。 方法：选择25例症状性单椎体血管瘤患者，其中颈椎3例，胸椎12例，腰椎10例。均在C型臂X射线机引导下行经皮聚甲基丙烯酸甲脂椎体成形治疗。治疗后摄X射线片观察椎体高度变化及骨水泥分布和渗漏情况，以目测类比评分及Oswesty功能障碍评分评定疼痛缓解及功能恢复情况。 结果与结论：所有手术均顺利完成，未发生脊髓及神经损伤。术中共3节椎体发生骨水泥渗漏，但未出现不适症状。25例患者均获随访10-26个月，疼痛症状均有不同程度改善，治疗后手术椎体高度无明显丢失，椎体无塌陷，血管瘤无复发。表明经皮椎体成形作为治疗症状性椎体血管瘤的理想方法，具有微创、低风险、易恢复、疼痛缓解迅速等优点，但对于椎体皮质有破坏者，需注意骨水泥渗漏的发生。

Polymethyl methacrylate cement injection in vertebroplasty

BACKGROUND: Percutaneous vertebroplasty can embolize vertebral hemangioma, strengthen vertebral strength, and has analgesic effect. OBJECTIVE:To investigate the clinical effects of percutaneous vertebroplasty in the treatment of symptomatic cervical, thoracic, and lumbar hemangiomas. METHODS: A retrospective analysis was performed in 25 patients who had single cervical (n=3), thoracic (n=12) or lumbar (n=10) vertebral hemangioma and accepted percutaneous vertebroplasty via polymethyl methacrylate cement injection under C-arm X-ray guidance. Ordinary radiographs were performed to observe the changes of the vertebral height and distribution and leakage of bone cement postoperatively. The local pain was measured by visual analogue scale and Oswesty functional scores preoperatively and postoperatively. RESULTS AND CONCLUSION: No spinal cord and nerves injury occurred during the operation. The visual analogue scale and Oswesty scores had a significant decrease 3 days after operation and at the final follow-up   (P < 0.05). During the follow-up periods, there was no significant vertebral height loss (P > 0.05), and no vertebral hemangioma recurrence happened. Percutaneous vertebroplasty is an effective therapeutic option for symptomatic vertebral hemangiomas, which has the characteristics of minimally invasive, low-risk, short recumbent period, and rapid pain relief. However, more attention should be paid in cortex deficiency cases to avoid bone cement leakage.