摘要
目的 探讨椎体严重压缩骨折行经皮穿刺椎体成形术 (PVP)治疗的操作技术和止痛效果。 方法 对 7例压缩程度超过 6 5 %的椎体骨折在俯卧位或侧卧位实施透视引导下经单侧椎弓根穿刺注射骨水泥PVP治疗。 结果 7例皆穿刺成功 ,1例椎体血管造影外漏严重未注射骨水泥 ,余每个椎体注射骨水泥量 0 5ml～ 2ml。术后 2天疼痛强度评分 (VAS)较术前下降 3 5分～ 5 0分 (t=8 4 9,P <0 0 0 0 5 ) ,随访时维持该水平 ;止痛药使用皆降低 1～ 2个阶梯 ,术后随防 2月～ 8月 (平均 6月 ) ,4例活动能力改善。 结论 椎体严重压缩骨折可透视引导下进行PVP治疗 ,并有良好疗效。
Objective To evaluate the technique and effectiveness of percutaneous vertebroplasty (PVP) for severe vertebral compression fracture. Methods Guided by C-arm fluoroscopy, PVP with transpedicular injection of cement was performed in 7 patients with vertebral compression fractures greater than 65% of the original vertebral body height, in a prone position or lateral recumbent position. Results Punctures were successfully completed in all the 7 cases. Polymethylmethacrylate (PMMA) was injected into vertebral bodies in 6 cases, while the remaining 1 case was lost to injection because of abnormal leakage of contrast material during venography. Of the 6 cases, the mean amount of PMMA injected was 1.2 ml (range, 0.5～2.0 ml). Two days following the operation, pain decreased by 5.0～3.5 on the visual analogue scale (VAS) pain rating (t=8.49, P<0.005), decreased analgesic use for 1～2 levels was obtained, and the patient's mobility was improved in 4 cases. Follow-up for 2～8 months (mean, 6 months) showed the VAS rating essentially unchanged in 2 cases and further decreased by 0.5～2.0 in 4 cases. Conclusions Severe vertebral compression fracture can be effectively treated by fluoroscopy-guided PVP.
出处
《中国微创外科杂志》
CSCD
2003年第4期294-296,共3页
Chinese Journal of Minimally Invasive Surgery
