摘要
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。
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 fol ow-up (P < 0.05). During the fol ow-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 minimal y 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.
出处
《中国组织工程研究》
CAS
CSCD
2013年第21期3823-3830,共8页
Chinese Journal of Tissue Engineering Research
关键词
生物材料
组织工程骨材料
椎体血管瘤
经皮椎体成形
骨水泥
聚甲基丙烯酸甲脂
椎体高度
疗效研究
目测类比评分
biomaterials
tissue-engineered bone materials
spinal vertebral hemangioma
percutaneous vertebroplasty
bone cement
polymethyl methacrylate
vertebral height
clinical efficacy
visual analogue scale
