经皮椎体成形填充剂骨水泥渗漏的研究现状

背景：经皮椎体成形是一项安全、有效的微创手术。 目的：综述经皮椎体成形中有关骨水泥渗漏的研究现状及新进展。 方法：由第一作者检索1980至2012年 PubMed数据库及CNKI数据库中有关经皮椎体成形中骨水泥渗漏的文献,英文检索词为“Percutaneous vertebroplasty,cement leakage”,中文检索词为“经皮椎体成形,骨水泥渗漏”。 结果与结论：通过经皮穿刺向椎体内注射骨水泥可增强椎体强度,稳定椎体,达到止痛目的,避免了开放手术的并发症;操作简单,效果显著,止痛确切、迅速,并发症少,安全性相对高。但经皮椎体成形需要通过经皮穿刺向病椎注入骨水泥,因而可能会伴发因骨水泥注入导致的并发症,尤其是骨水泥渗漏。虽然大部分无临床症状,但灾难性的并发症也可能会发生。了解骨水泥渗漏发生的原因、部位、症状,对制定骨水泥渗漏预防策略、减少其发生率、提高手术安全性都有重要临床意义。

Cement leakage in percutaneous vertebroplasty

BACKGROUND:Percutaneous vertebroplasty is a minimally invasive and safe surgical technique. OBJECTIVE:To overview the current status and new advancement of cement leakage in percutaneous vertebroplasty. METHODS:The first author searched the literatures related to cement leakage in percutaneous vertebroplasty in the PubMed and CNKI databases (1980/2012) using the keywords of “percutaneous vertebroplasty, cement leakage” in English and Chinese, respectively. RESULTS AND CONCLUSION:The aim of this procedure is to enhance the mechanical strength of the vertebra and obtain pain relief. It can avoid the complications of open vertebroplasty and have broken a new ground for the treatment of osteoporotic vertebral compression fractures and vertebral metastases. Percutaneous vertebroplasty has been widely accepted by the doctors and patients due to its simple procedure, low complication rate and effect in alleviating pain. However, percutaneous vertebroplasty is not free of complications, especially associated with cement leakage. Although extravasations of polymethylmetharylate during percutaneous vertebroplasty are usually asymptomatic, devastating complications may occur. To determine the reasons of cement leakage in percutaneous vertebroplasty will help us to make preventive strategies, reduce complications and promote the security of the procedure.