经皮椎体成形术治疗胸腰椎血管瘤的临床分析

Percutaneous Vertebroplasty for the Treatment of Thoracic and Lumbar Vertebral Hemangioma

【目的】探讨经皮椎体成形术治疗胸、腰椎血管瘤的手术方法及疗效。【方法】2000～2005年收治18例22个椎体血管瘤患者,均行经皮椎体成形术治疗。所有患者均经临床、影像学及术后病理检查确诊并排除禁忌证。患者术前疼痛视觉模拟评分（visual analogue pain scale,VAS）为（7.5±1.6）。【结果】随访1～4.5年,平均2.3年。术后24 h患者疼痛基本消失6例,明显缓解9例,部分缓解2例,未缓解1例,优良率为83.3%,术后48 h疼痛视觉模拟评分（VAS）为（1.5±0.8）。3个月后患者疼痛等症状基本消失,椎体高度未继续丢失,肿瘤未见复发。发生骨水泥渗漏3例4椎,均未引起患者症状加重。【结论】经皮椎体成形术治疗脊椎血管瘤能凝滞病变、固化椎体、稳定脊柱、解除症状,是一种安全有效的微创治疗方法。

[Objective]To investigate the treatment methods and efficacy of percutaneous vertebroplasty for the treatment of thoracic and lumbar Vertebral Hemangioma. [Methods] From 2000 to 2005, eighteen patients with vertebral hemangioma were diagnosed by clinical, radiological and pathological examinations. All patients without contraindication were received percutaneous vertebroplasty. The visual analogue pain scale （VAS） of patients before operation was 7.5±1.6. [Results] The average time of follow up of 18 patients was 2.3 years （ranged from 1 to 4.5 years）. Pains of 6 patients were released completely, 9 patients were released well, 2 patients were released little, and one patient was not released absolutely in 24 hours after operation. The ratio of fineness was 83.3%. The VAS of patients in 48 hours after operation was 1.5±0.8. In 3 months after operation, pains of all patients were released completely, the vertebral height of them was not lost, and no case with hemangioma recurred. Bone cement leakage occurred in 3 cases （4 vertebra） without deterioration. [Conclusion] Percutaneous vertebroplasty, which can stagnate the pathological changes, solidify the centrums, stabilize the vertebral and release the symptoms of patients, was a safe, effective and minimally invasive procedure for the treatment of vertebral hemangioma without paraplegia.