骨水泥混合与注射一体化装置行经皮椎体成形术治疗椎体压缩性骨折

Percutaneous vertebroplasty in the treatment of vertebral body compression fracture with bone cement mixing and injection integrative system

目的 探讨骨水泥混合与注射一体化装置行经皮椎体成形术治疗椎体压缩性骨折的操作技术、临床疗效。方法 2 0 0 2～2 0 0 4年间共计治疗了1 0 8例诉有严重疼痛的椎体压缩性骨折患者,其中骨质疏松性压缩性骨折85例,椎体恶性肿瘤31例。穿刺入路采用双侧椎弓根穿刺法,所有患者均在透视监视下双侧注射聚甲基丙烯酸甲酯(polymethylmethacrylate,PMMA) ,注射设备为骨水泥混合与注射一体化装置。术后随访患者6个月。结果 共计注射1 1 6个椎体(腰椎6 9个,胸椎4 7个) ,双侧穿刺和骨水泥注射成功率1 0 0 %,99例患者(91 .7%)术后疼痛明显缓解,6个月内疼痛无复发95例(95 .6 %) ,9例患者(8.3%)术后疼痛无缓解。发生骨水泥外漏1 2例(1 1 %) ,有临床症状5例(4.6 %)。结论 骨水泥混合与注射一体化装置行经皮椎体成形术创伤小、并发症少,而且止痛疗效显著,是一种非常有前景的治疗椎体压缩性骨折的介入手术方法。

Objective To evaluate the techniques and curative effects of percutaneous vertebroplasty (PVP) in vertebral compression fractures with bone cement mixing and injection integrative system. Methods 108 patients with painful vertebral compression fractures(VCFs) were undergone PVP treatment in two years. There were 85 patients with osteoporotic VCFs and 31 patients with malignant VCFs. Polymethylmethacrylate(PMMA) were injected into the vertebral bodies via the bipedicular approach under fluoroscopic guidance with bone cement mixing and injection integrative system. Postvertebroplasty follow-up were achieved in six months. Results Total 116 (100%) vertebral bodies (69 lumbar vertebrae and 47 thoracic vertebrae) were successfully injected with bone cement through bipedicular approach. Marked pain relief was achieved in 99 patients(91.7%). 95 patients(95.6%) had no pain reversion in the next six months. Only 9 patients(8.3%) had no pain relief. The extravasations of bone cement were observed in 12 patients(11%), with only 5(4.6%) had clinical symptoms. Conclusions Percutaneous minimally vertebroplasty(PVP)is a minimally invasive and low complication mothod, with high efficacy for pain relief especially promising in the treatment of vertebral compression fractures.