【摘要】 目的评价经皮椎体成形术治疗椎体转移性骨肿瘤、骨质疏松压缩骨折所致脊背部疼痛的临床疗效,认识相关并发症及防治方法。方法对46例脊背部疼痛患者行PVP术,所有患者术前均经病史、影像学证实椎体转移性骨肿瘤(20例)或骨质疏松压缩骨折(26例),病变椎体节段共67节。术前及术后1d采用数字疼痛评分法(NRS)评测临床疼痛程度,用配对t检验进行统计学评价。术中、术后观察可能并发症及处理。结果 67节椎体均成功施行PVP术。疼痛评分(0~10)由术前8.4降至术后2.7(P<0.001)。术后影像学(平片、CT)证实骨水泥渗漏25例,其中椎旁软组织渗漏9例,椎间盘漏10例,椎管内硬膜囊外漏6例。1例椎管内硬膜囊外漏患者出现临床症状加重,药物治疗后症状缓解。无严重危急生命并发症(如:肺栓塞)发生。结论对因椎体转移性骨肿瘤、骨质疏松压缩骨折所致脊背部疼痛患者施行椎体成形术是安全、有效的,骨水泥渗漏是最常见并发症,症状性并发症发生率低。更多还原

【Abstract】 Objective To evaluate safety and analgesic effectiveness of performance of percutaneous vertebroplasty(PVP) in patients with vertebral body malignant tumors and osteoporotic vertebral body compression fractures.Methods PVP was performed in 46 patients with 67 vertebral malignant and osteoporotic vertebral body compression fractures verified by the history,imaging and pathology.Back pain quantitative measurement was performed with 11-point scale numerical rating scales(NRS)before and 1 day after the procedure.Differences in reported pain were evaluated with paired t tests.Imaging,clinical features and complications were analyzed.Results The success rate of technique reached 100 %.On a 11-point scale,mean pain decreased from 8.4 before vertebroplasty to 2.9 afterward(P<0.01).Postprocedural CT、X-ray confirmed 25 cement leaks,including 9 paravertebral leaks,10 intervertebral leaks and 6 epidural space leaks.One patients went worse with epidural space leaks,which were completely relieved with drugs.There were no instances of death,permanent neurologic injury,or symptomatic pulmonary embolism.Conclusion Treatment of vertebral fractures with percutaneous vertebroplasty appears to be safe and results in substantial immediate pain reduction.更多还原