椎体成形术中骨水泥局部渗漏对机体的影响及治疗对策

Investigate the infiltration on body of bone cement leakage and therapy in the way of vertebroplasty

目的探讨椎体成形术中骨水泥局部渗漏对机体的影响及治疗对策。方法甄选30例椎体成形术后出现骨水泥渗漏的患者,术后观察注射骨水泥椎体薄层CT（0.75 mm层厚）片。记录骨水泥渗漏的部位及相关的临床表现。结果骨水泥渗漏到椎管内2例（2个病椎）、椎弓根针道返流4例（5个病椎）,渗漏到椎间盘6例（8个病椎）、渗漏到椎体前9例（13个病椎）、渗漏到椎旁9例（12个病椎）。术后随访3~24个月,其中1例渗漏到椎管的患者术后出现左侧肢体剧烈疼痛,急诊手术减压治疗后疼痛缓解;3例渗漏到椎间盘术后的患者第1~2天出现腰背部胀痛,经积极保守治疗,症状缓解。结论椎体成形术中应尽量避免骨水泥渗漏,椎管以外少量骨水泥渗漏一般不引起严重后果,同样可取得满意的临床效果。

Objective To investigate the infiltration on body of bone cement leakage and therapy in the way of vertebroplasty.Method After the selection of 30 cases of vertebroplasty cement leakage in patients with vertebral body were observed after injection of bone cement thin CT（0.75 mm thick）pieces.Record the location of bone cement leakage and consequences.Results Bone cement leakage into the spinal canal in 2 cases（2 vertebra）,pedicle needle regurgitation in 4 cases（5 vertebra）,leakage to the disc 6（8 vertebra）,leakage into the anterior vertebral body 9 patients（13 vertebra）,leakage to the vertebra around 9 cases（12 vertebra）.Clinical follow-up 3~24 months,except for 1 case leakage into the spinal canal in patients with severe postoperative pain in the left limbs,emergency surgical decompression for pain relief;3 cases of leakage into the disc after the first 1-2 days in patients with lower back pain occurs,but after positive conservative treatment,symptoms.Conclusion Vertebroplasty cement leakage should be avoided even a small amount of cement leakage outside the spinal canal usually does not cause serious consequences,the same satisfactory clinical results.