经皮椎体成形术常见并发症及治疗对策

目的：探讨经皮椎体成形术的常见并发症及治疗对策。方法：对2003年10月至2006年12月应用经皮椎体成形术治疗的110例老年骨质疏松性脊柱压缩骨折进行回顾性研究,分析了并发症及治疗对策。结果：本组出现并发症37例,其中骨水泥渗漏至椎管内造成神经损伤2例,骨水泥注入至椎体旁治疗无效者1例,骨水泥渗漏至椎体旁以及椎间隙32例,术后3 d原位再次骨折2例。1例神经损伤患者术后2 d经保守治疗自行恢复,1例再次行开放手术取出椎管内骨水泥,神经功能部分恢复,其余患者经过制动等治疗后症状缓解。结论：椎体成形手术创伤小,但风险大,骨水泥渗漏至椎管内造成神经损伤是最严重的并发症,及时、正确的处理可以将神经损伤程度降至最低。

Complications of percutaneous vertebroplasty and their treatment countermeasures

Objective：To explore the complications of percutaneous vertebroplasty and relevant therapies. Methods：A total of 110 cases of senile osteoporotic vertebral compression fracture from Oct 2003 to Dee 2006 treated with percutaneous vertebroplasty were retrospectively reviewed. The complications and therapies were investigated. Results：Thirty-seven ca- ses presented complications. Two of them suffered nerval damage resulting from leaking of bone cement into vertebral canal. One case showed no effect on account of bone cement injection into the side of the vertebrae. Thirty-two eases showed ce- ment leaking out of the vertebrae or into the intervertebral space. Two cases got refracture in situ three days after operation. One case with nerval damage recovered two days after conservative treatment, and another case got partial restoration of the nerval function after removing the cement mass in the vertebral canal through open operation. In all the other cases had their symptoms relieved by fixation. Conclusion： Percutaneous vertebroplasty is a good choice for senile osteoporotic vertebral compression fracture with minimal invasion, but the risk is relatively high. The most serious complication is nerval damage by the leaking of bone cement into the vertebral canal, which demands prompt and proper treatment to minimize the afteref- fect on the nerval system.