首发症状为腰腿痛的脊髓血管病血管内治疗与术后康复干预

Endovascular treatment and postoperative rehabilitation intervention for spinal vascular diseases with the primary symptoms of lumbago and leg pain

目的:探讨首发症状为腰腿痛的脊髓血管病的血管内治疗与术后康复干预的疗效。方法:脊髓内血管畸形6例,脊髓周动静脉瘘1例及硬脊膜动静脉瘘1例,采用聚乙烯醇(PolyvinylAlcohol,PVA)颗粒、α-氰基丙烯酸正丁酯(N-Butylcyanoacrylate,NBCA)、螺旋圈(Coil)栓塞治疗的同时,采取神经功能康复治疗。结果:8例均进行经血管内栓塞治疗,5例供血动脉完全栓塞,占62.5%(5/8);供血动脉大部分栓塞,占37.5%(3/8),仅余细小的动脉供血。术后经过进一步康复干预治疗后,6例腰腿痛症状消失,占75%(6/8),2例明显改善,占25%(2/8),神经功能恢复满意。结论:采用经血管内栓塞是治疗脊髓血管病的一种微创、安全、有效的方法,栓塞术后的康复治疗是促进脊髓神经功能恢复的必要手段。

AIM:To discuss the curative effect of the endovascular treatment and postoperative rehabilitation intervention in treatment of spinal vascular diseases with the primary symptoms of lumbago and leg pain.METHODS:Eight cases of spinal vascular diseases with the primary symptoms of lumbago and leg pain, 5 males and 3 females with an average age of 38.1 years, including 6 cases of intramedullary arteriovenous malformations,1 case of perimedullary arteriovenous fistulas and 1 case of spinal dural arteriovenous fistulas were embolized with Polyvinyl Alcohol (PVA), Coils, or/and N Butylcyanoacrylate (NBCA).At the same time they accepted the therapy of rehabilitation. RESULTS:Endovascular embolization was performed in all the cases. Of all the cases feeding arteries were embolized completely in 62.5% ( 5/8) ; partially embolized in 37.5% ( 3/8) ,and only small feeding arteries exited. The symptoms of lumbago and leg pain disappeared in 75% ( 6/8) and alleviated obviously in 25% ( 2/8) . And it was satisfactory in the recovery of neurological function.