椎体成形术缓解疼痛和稳定脊柱的影像和临床评价

目的:探讨经皮穿刺椎体成形术治疗脊柱病变对缓解疼痛和稳定脊柱的价值.材料和方法:对45例共62个椎体行经皮穿刺椎体成形术,其中血管瘤4例4个椎体、骨质疏松7例13个椎体、椎体恶性肿瘤34例46个椎体.经CT扫描定位,将不透X线骨水泥(主要成分为粉剂甲基丙烯酸树脂多聚体和液态甲基丙烯酸树脂单体)按粉剂与液体为4:1比例混合调制成糊状,用1ml注射器匀速缓慢注入病变椎体.结果:本组完全缓解(CR)率77.78%,部分缓解(PR)率17.78%,有效率为95.56%.其中7例骨质疏松症所致压缩性骨折者获CR4例,PR3例;4例血管瘤患者3例获CR,1例获PR;34例恶性瘤中28例获CR,4例获PR.止痛作用2周至18个月持续有效.CT和平片随访观察骨水泥密度、形态与术后所见无变化,未见椎体进一步压缩.结论:经皮穿刺椎体成形术适用于椎体血管瘤、骨质疏松、转移瘤等溶骨性病变,具有稳定脊柱和减轻疼痛的作用.

Clinical Applications of Percutaneous Vertebroplasty for Spinal Stabilization and Pain Relief

Purpose:To investigate the clinical applications of percutaneous vertebropl asty(PVP) for spinal stabilization and pain relief.Materials and Methods:Fort y-five patients underwent 62 PVP including 4 vertebral nemangiomas with 4 PVP, 7 osteoporosis with 13 PVP, and 34 vertebral malignant tumors with 46 PVP. PVP was done with radiopaque bone cement under the CT guidance.The ratio of powdery polymethl methacrylate to liquid methl methacrylate was 4:1 .The ropy paste was mixed and slowly injected using 1ml syringe.Results:The analgesic effectivenes s was 95.56%.The rate of CR is 77.78%and the rate of PR is 17.78%. There are 4 CR and 3 PR cases in the 7 vertebral osteoporosis fractures. There are 3 CR and 1 PR cases in the 4 vertebral hemangioma and there are 28 CR and 4 PR ca ses in the 34 osteolytic metasteses. the analgesic time began from PVP and laste d from 2 weeks to 18 months. The density and form of bone cement were unchanged on follow-up imaging. No further compression of vertebral body occurred.Conclu sion :The indications of PVP are the vertebral hemangioma, vertebral osteoporosi s, osteolytic metasteses, and other osteolytic diseases. PVP has the ability of pain relief and spinal stabilization. No complication was seen in this group.