经皮椎体成形术骨水泥渗漏的危险因素研究进展

Study progress in identificating risk factors of bone cement leakage in vertebroplasty

骨质疏松性椎体压缩骨折病人会出现严重的疼痛症状,经皮椎体成形术已成为治疗该疾病的一种重要方法。但椎体成形术需要经皮穿刺向病椎注入骨水泥,而骨水泥渗漏有可能会导致椎体再骨折、肺栓塞、脊髓压迫所致截瘫等严重的并发症。了解术前椎体的某些重要影像征象(如骨皮质不完整、椎体终板损伤、骨折程度严重、骨密度高、椎体裂隙征等)对骨水泥渗漏的影响,并对此采取防范措施有着非常重要的临床意义。就影响骨水泥渗漏的术前危险因素予以综述。

Patients with osteoporotic vertebral compression fractures(OVCFS)may develop severe pain symptoms.Percutaneous vertebroplasty(PVP)is an important method for the treatment of the disease.However,vertebroplasty is required to inject bone cement into the vertebral body through the percutaneous puncture,and the leakage of bone cement can lead to serious complications such as vertebral refracture,pulmonary embolism,and spinal cord compression which may lead to paraplegia.It is very important to understand the influence of some important imaging signs on the leakage of bone cement(including cortical disruption,vertebral endplate injury,high fracture severity,high bone mineral density,intravertebral cleft,etc),and to take preventive measures in advance.The preoperative risk factors affecting bone cement leakage were mainly reviewed in this paper.