经皮酒精栓塞联合经皮椎体成形术治疗硬膜外侵袭性椎体血管瘤

Percutaneous alcohol embolization combined with percutaneous vertebroplasty in epidural extension of aggressive vertebral hemangiomas

目的评估经皮酒精栓塞(PAE)联合经皮椎体成形术(PVP)治疗向硬膜外侵袭椎体血管瘤的安全性及疗效。方法回顾性分析2013年10月至2015年11月我院收治的硬膜外侵袭性椎体血管瘤且接受皮酒精栓塞(PAE)联合经皮椎体成形术(PVP)的26例患者的临床资料,随访时间(12.21±1.34)个月,采用视觉模拟评分法(VAS)对患者术前及术后临床疼痛症状进行评分。结果术前VAS评分为(7.23±1.3)分,术后末次随访VAS评分为(3.11±1.9)分,其中10例患者没有症状,有88%合并感觉障碍的患者术后完全恢复,3例合并术前有肌力减退的患者中有2例没有任何改善。结论经皮酒精栓塞(PAE)联合经皮椎体成形术治疗硬膜外侵袭性椎体血管瘤具有微创、安全、有效的特点,对缓解疼痛及恢复感觉障碍均有一定的疗效,但对于肌力改善疗效不明显。

ObjectiveTo evaluate the safety and effectiveness of percutaneous alcohol embolization（PAE） combined with percutaneous vertebroplasty（PVP） for aggressive vertebral haemangiomas（AVHs） with epidural extension.MethodsThe data of 26 consecutive patients underwent PAE combined with PVP for the treatment of AVHs with epidural extension from October 2013 to November 2015 were analyzed retrospectively.The average follow up time was （12.21±1.34） months.The pain symptom before and after surgery were evaluated with a visual analogue scale（VAS）.ResultsPre procedure mean VAS score was （7.23±1.3） and the postoperative VAS score was （3.11±1.9）at last follow up.Ten patients（38.5%） remained asymptomatic.Eighty eight percent of the patients with neurosensory disorders had complete regression of these symptoms.Two of the three patients with motor deficit did not show any improvement.No major complication was recorded.ConclusionPAE combined with PVP is a minimally invasive safe and effective therapeutic approach for AVH with epidural extension.This technique appears mainly effective for pain and neurosensory symptoms,but seems less effective for motor deficit relief.