椎体成形术骨水泥渗漏部位及防治

The site of bone cement leakage and its prevention in vertebroplasty

目的探讨椎体成形术出现骨水泥渗漏的部位及预防措施。方法对46例椎体成形术中出现骨水泥渗漏的患者通过影像学检查观察注射骨水泥椎体的渗漏情况,记录骨水泥渗漏的位置及渗漏所产生的临床表现,分析渗漏原因,提出防治措施。结果椎管内骨水泥渗漏6例,椎间盘内骨水泥渗漏9例,椎旁软组织骨水泥渗漏10例,穿刺针道拖尾骨水泥渗漏10例,椎体前骨水泥渗漏11例。38例无需处理病情得到有效控制与缓解;3例椎管内骨水泥渗漏者术后出现肢体剧烈疼痛,经过急诊手术和减压治疗之后疼痛得到缓解;5例椎间盘骨水泥渗漏者术后第1-3天出现不同程度的腰背酸痛,采用相对应的方法进行治疗,疼痛缓解。结论加强术中规范操作流程、熟练而精确的手术操作、完善影像监测可以有效预防椎体成形术中骨水泥渗漏的发生。

Objective To discuss the site of vertebral body bone cement leakage and its preventive action. Methods46 patients with bone cement leakage were selected after surgery. The bone cement leakage by imaging examination were observed,the site of the bone cement leakage and the leakage of clinical manifestations were recorded. After analyzing the causes of leakage,preventive action was applied. Results Spinal canal leakage of bone cement was found in 6 cases,intervertebral discs 9 cases,10 cases of vertebral soft tissue by bone cement leakage,10 cases of needle pulling the tail bone cement leakage,anterior of vertebral bone cement leakage in 11 cases. 38 patients without dealing with the condition was effectively controlled with ease; 3 patients with bone cement leakage of spinal canal appeared low limbs acute pain after the operation,ease pain after emergency operation and decompression therapy; 5patients with disc leakage of bone cement appeared different degrees of lower back pain,through using the method of corresponding treatment,the 1 - 3 days pain was greatly reduced. Conclusions Strengthening standard operation procedures,skilled and precise operation,perfect image monitor can effective prevention of bone cement leakage during vertebroplasty