骨水泥注入硬脊膜外腔后脊髓损伤的实验研究

An Experimental Study of Effect of Injection of Bone Cement into Spinal Epidural Cavity on Spinal Cord

目的观察骨水泥注入犬硬脊膜外腔后可能造成的脊髓损伤,更好地防止椎体成形术后并发症的发生。方法在12只犬中1.5～2m l的骨水泥被注入硬脊膜外腔。实验组在注入骨水泥后2h内行去椎板减压骨水泥清除术,评定脊髓神经功能,48h后取犬的脊髓标本,进行病理学检查。结果骨水泥注入硬脊膜外腔可引起明显的脊髓挫伤表现,及时减压后可降低脊髓受损程度。结论临床应用椎体成形术时需要防止骨水泥漏入椎管内,一旦引起脊髓功能障碍,应及时手术去椎板减压。

Objectives To investigate the effect of spinal epidural injection of bone cement on spinal cord and to prevent the complications after vertebroplasty. Methods A dose of 1.5～2 ml of polymethyl methacrylate (PMMA) was injected into the spinal epidural cavity in each of 12 dogs who were averagely divided into experimental and control groups. Six dogs in the experiment group received decompression of spinal cord by vertebrectomy and removal of PMMA in the spinal epidural cavity, and did not in the control group. The nerves function evaluation was performed and the spinal cords were subjeted to histologic examination 48 hours after the injection of PMMA. Results Contusion of spinal cord was induced by injection of PMMA into spinal epidural cavity, and the spinal cord injury was more serious in the control group than that in the experimental group. Conclusions The bone cement should be prevented from leaking into the vertebral canal when the vertebroplasty is performed. The decompression of spinal cord is performed as soon as the sympsom of spinal cord injury appears.