经皮穿刺椎体成形术的临床应用价值

Clinical applications of percutaneous vertebroplasty

目的 探讨经皮穿刺椎体成形术的临床应用价值。方法 对 5 7例共 79个椎体行经皮穿刺椎体成形术 ,其中血管瘤 6例 6个椎体、骨质疏松 9例 16个椎体、椎体恶性肿瘤 42例 5 7个椎体。经CT扫描定位 ,将不透X线骨水泥 (主要成分为粉剂甲基丙烯酸树脂多聚体和液态甲基丙烯酸树脂单体 )按粉剂与液体为 4∶1比例混合调制成糊状 ,用 1ml注射器匀速缓慢注入病变椎体。结果 经皮穿刺椎体成形术后 ,骨水泥在CT表现为点状分布 3个 ,斑片状分布 6个 ,团状分布 42个 ,弥散分布2 8个。CT和平片随访观察骨水泥密度、形态与术后所见无变化 ,未见椎体进一步压缩。 15例良性病变全部达到止痛效果 (15 / 15 ) ,恶性肿瘤止痛效果达 90 5 % (38/ 42 )。止痛从注入骨水泥开始到 7d显效 ,持续 6个月。本组没有发生并发症。结论 经皮穿刺椎体成形术适用于椎体血管瘤、骨质疏松、转移瘤等溶骨性病变。

Objective To investigate the clinical applications of percutaneous vertebroplasty (PVP) Methods Fifty seven patients underwent 79 PVP including 6 vertebral hemangiomas with 6 PVP, 9 osteoporosis with 16 PVP, and 42 vertebral malignant tumors with 57 PVP PVP was done with radiopaque bone cement under the CT guidance The ratio of powdery polymethl methacrylate to liquid methl methacrylate was 4∶1 The ropy paste was mixed and slowly injected using 1 ml syringe Results Bone cement presented as dot form in 3 PVP, spot form in 6 PVP, group form in 42 PVP, and homogenous form in 28 PVP The density and form of bone cement were unchanged on follow up imaging No further compression of vertebral body occurred The analgesic effectiveness was 100% (15/15 patients) in begin lesions and 90.5% (38/42 patients) in malignant tumors, and the analgesic time began from PVP to 7 days and lasted for 6 months Conclusion The indications of PVP are the vertebral hemangioma, vertebral osteoporosis, osteolytic metastases, and other osteolytic diseases No complication was seen in this group