【摘要】 目的通过C形臂X线机透视下进行经皮穿刺椎体成形术治疗胸腰椎病理性骨折,探讨该技术的临床疗效及应用注意事项。方法本组21例(25个椎体),其中男8例,女13例;年龄46～74岁,平均61.4岁。脊柱病理性骨折部位为T10～L4,其中胸椎3个椎体,腰椎18个椎体。俯卧位下采用C形臂X线机透视引导进行经皮穿刺椎体成形术,注射聚甲基丙烯酸甲酯(骨水泥)。在术前、术后2d、随访期进行腰背痛Dennis分级评估。结果21例25个椎体穿刺均获得成功,胸椎注射骨水泥2.5～5.0ml,平均为3.5ml;腰椎注射骨水泥5.5～8.0ml,平均为6.0ml。3例患者3个椎体(12%)骨水泥外溢,患者无阳性体征和其他并发症,未予特殊处理。16例患者术后立即止痛,3例患者术后1天止痛,余2例1周内疼痛明显缓解。随访时间3～9个月,平均5.4个月。所有患者腰背痛均明显缓解。复查胸腰椎X线片未发现椎体高度丢失。结论经皮穿刺椎体成形术可有效重建病理骨折椎体,止痛效果好,有利于提高患者生活质量,C形臂X线机透视监视即可满足大多数患者手术需要。更多还原

【Abstract】 Objective To evaluate the outcomes and problems of X-ray fluoroscopy guided percutaneous vertebroplasty (PVP) in treating thoracic and lumbar vertebra pathological fracture.Methods Twenty-one patients (13 females and 8 males) with 25 vertebral compression fractures underwent PVP. The average age was 61.4 years (range:46～74years).The fracture segment was within T10～L4 (3 thoracical vertebrae, 18 lumbar vertebrae).With the guidance of C-arm fluoroscopy , bone marrow biopsy needle was inserted percutaneously via transpedicular way into the fracture vertebrae, then polymethylmethacrylate(PM MA) was injected into it. The pain and mobility were evaluated 2 days before and after the operation and in the follow-up period.Results PVP was successful in 21 cases (25 vertebrae ) .The average volume of PMMA injected into thoracic vertebra was 3.5 ml per vertebrae, and 6.0ml into the lumbar vertebra .The average follow-up period was 5.4 months (3~9 months) .The back pain in all patients was relieved,and there were no loss of vertebra height.Conclusion PVP is an effective mini-invasive technique to reconstruct the pathological fracture vertebra and relieve the pain,it can be accomplished safely with a C-arm planefluoroscopy in most cases.更多还原