经皮椎体成形术治疗活动期椎体血管瘤临床疗效分析

Clinical appliciation of percutaneous vertebroplasty for vertebral hemangioma in active stage

目的探讨经皮椎体成形术(PVP)治疗活动期椎体血管瘤的临床疗效,总结临床经验。方法回顾分析2006年8月至今共计23例活动性椎体血管瘤患者,平均年龄47岁,行经PVP治疗,所有患者均经临床、影像学及术后病理确诊,并排除手术禁忌证。结果 23例患者病变椎体均成功完成手术,术后平均随访22个月,术后腰背部疼痛17例显著改善,6例改善,末次随访疼痛均显著改善,无复发,负重活动状况明显好转。术后X线片、CT显示骨水泥填充病灶良好,分布均匀,4例见椎旁静脉渗漏,均未出现神经损伤症状,未出现骨水泥过敏反应及栓塞等并发症。结论 PVP能显著缓解活动期椎体血管瘤引起的顽固性腰背部疼痛,是一种安全、有效的微创治疗方法,具有广泛的应用前景。

Objective To investigate the clinical refficacy of percutaneous vertebroplasty （PVP） for vertebral hemangioma in active stage, and to summarize the clinical experience. Methods 23 patients with vertebral hemangioma in active stage who were treated from August 2006 until now underwent PVR Their average age was 47. All patients were confirmed through clinical, radiological and post-operative histological examinations. All contraindications were ruled out. Results All patients＇ data were retrospectively analysed. PVP were successfully performed on the affected intevertebral bodies in these 23 patients. All patients were followed up for 22 months on average. 17 patients reported significant low back pain relief, and 6 reported medium relief. In the last follow-up, all patients showed significant improvement with no relapse. The patients showed better condition when they did activities carrying weight. Post- operative X-ray and CT scan indicated that the bone cement filling was uniformly distributed. 4 patients showed venous leakage next to the intervetebral body without neurological impairment, bone cement allergy or embolism. Conclusions Percutaneous vertebroplasty can significantly relieve intractable low back pain caused by vertebral hemangioma in active stage. It is a safe and effective minimal invasive procedure which shows the prospect of extensive application.