经皮椎体成形术在治疗多种椎体疾病引起的疼痛中的应用

Application of percutaneous vertebralplasty in the treatment of pain caused by vertebral diseases

目的探讨经皮注射骨水泥椎体成形术(PVP)在缓解由多种椎体疾病引起的疼痛的临床效果。方法在大型C臂X线机透视下,采用经单侧或双侧椎弓根骨水泥注射法行PVP治疗椎体疾病患者23例,观察其临床疗效及并发症。结果 23例椎体疾病患者中包括椎体压缩性骨折、椎体血管瘤、椎体外伤性骨折及椎体转移瘤等疾病,本组病例共32个椎体行PVP治疗,技术成功率100%,其中17例患者术后疼痛完全缓解(CR);4例术后部分缓解(PR),1例术后轻微缓解,1例无改善。总有效率91.3%。5例骨水泥外溢至椎间盘内,3例骨水泥外溢至椎体后缘静脉丛,未出现临床症状,全部病例未出现严重并发症。结论 PVP术在治疗多种椎体疾病中安全有效,能明显地缓解疼痛和加固椎体,是一种值得临床推广应用的治疗。

Objective To explore the clinical value of percutaneous vertebroplasty （PVP） in the treatment of pain caused by vertebral diseases. Methods Guided by large C-arm X-ray, PVP was performed in 23 cases with vertebral diseases. The clinical effects and com- plications were observed. Results 23 cases of vertebral disease patients included vertebral body compressibility fracture, vertebral he- mangioma,vertebral body traumatic fractures and vertebral body metastatic tumor. All the 32 vertebras were successfully treated by PVP, technical success rate 100%. Complete relief（CR） of pain was demonstrated in 17 cases, partial relief（PR） in 4 cases, slight relief 1 case ,no improvement 1 case. The total effect rate was 91.3%. In 5 cases bone cement spilled over to intervertebral disc ,while in other 3 cases bone cement spilled over to vertebral rear edge venous plexus. There were no clinical symptoms and severe complications in all cases. Conclusion PVP is a safe and effective treatment for vertebral diseases,which can obviously relieve pain and reinforce vertebrae.