经皮椎体强化术并发症发生及对策

Percutaneous vertebral augmentation: its complications and countermeasures

经皮椎体强化术(PVA)包括经皮椎体成形术(PVP)、经皮椎体后凸成形术(PKP),目前已成为治疗疼痛性椎体病变的有效介入手段。总体上,PVA并发症发生率较低,但严重并发症一旦发生,即严重影响手术疗效和患者预后。PVA并发症可分为骨水泥渗漏相关并发症、脂肪栓塞、骨水泥特质反应、生物力学相关并发症及操作相关并发症。本文就PVA并发症与防治对策进行综述,建议严格掌握手术适应证,严格遵守操作规程,尽可能减少或避免并发症发生。

Nowadays, percutaneous vertebral augmentation （PVA）, which includes percutaneous vertebroplasty （PVP） and percutaneous kyphonplasty （PKP）, has become the most effective interventional method for painful vertebral lesions. Generally speaking, the complication incidence of PVA is lower, but once severe complications occur, the operative outcome and prognosis will be seriously affected. The complications caused by PVA include bone cement leakage-related complications, fat embolism, idiosyncratic reaction to bone cement, biomeehanics-related complications and operation-related complications. This article aims to make a review about the complications of PVA and their prevention and treatment. Strict observation of operation indications and operating instructions are strongly suggested in order to reduce or avoid the occurrence of complications as much as possible.（J Intervent Radiol, 2017, 26： 769-774）