CT透视引导下经皮椎体成形术治疗骨质疏松性椎体骨折效果

目的评价CT透视引导经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩性骨折的效果.方法在CT透视引导下对13例因椎体骨质疏松性骨折所致疼痛患者女9例,男4例,平均年龄61岁,病程＜3个月,19个椎体(胸椎、腰椎)]实施PVP,对其疼痛缓解、活动状况恢复进行观察和随访.结果 11例术后24h内疼痛完全和显著缓解,2例3 d疼痛完全和显著缓解,均能下床活动.全部病例停用止痛药.术后CT检查发现3个椎体有骨水泥渗漏.2例见聚甲基丙烯酸甲酯(polymethylacrylate methylmethacrylate,PMMA)复合物进入椎间盘,未出现疼痛等症状.1例少量PMMA复合物漏至椎旁.10例随访3个月,PVP后均未见椎体进一步压缩.结论 CT透视引导PVP是一项安全有效的治疗骨质疏松性椎体压缩性骨折的方法.

Percutaneous vertebroplasty guided by CT fluoroscopy for vertebral body osteoporotic compression fractures

Objective To evaluate the clinical efficacy of percutaneous vertebroplasty (PVP) guided by CT fluoroscopy for the treatment of back pain associated with vertebral body osteoporotic compression fractures. Methods Thirteen patients (male: 9; female: 4; mean age: 61 years old) underwent 19 percutaneous injections of polymethyl methacrylate (PMMA) into the vertebra in 13 patients under CT fluoroscopic guidance over a 1-year period. The pain relief and recovery of activities were observed during the follow-up period. Results The procedure was technically successful in all patients. The patients reported complete or significant pain relief at 24 h after treatment, but the other 2 patients reported pain relief at 48 h after treatment. All patients stopped analgesic medication and could do out-of-bed activities. Complications were found in 3 patients: PMMA spillaged into the intervertebral discs in 2 patients and leaked into the paravertebral space in 1 patient, but all of them had no symptoms. The compression was resistant in all 10 patients in the follow-up for 3 months. Conclusion Percutaneous vertebroplasty for symptomatic vertebral body compression fractures is a minimally invasive procedure that can provide immediate and sustained pain relief in patients with refractory pains.