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目的探讨经皮椎体成形术(percutaneousvertebroplasty,PVP)治疗症状性脊椎血管瘤的临床效果。方法共11例患者,男2例,女9例;年龄35~77岁,平均54.3岁;均有背部疼痛等症状,其中2例有神经根刺激症状;病变部位:胸椎11处,腰椎3处;在DSA或CT监测下对16个椎体(包括2处骨质疏松压缩骨折)行PVP。术后行CT检查。随访3～34个月(平均15.2个月)。结果11例PVP后均未出现肺栓塞、神经损伤等并发症,术后CT检查示均无椎管内或椎间孔渗漏。仅2例2椎存在椎旁少量渗漏,1椎系穿刺针穿破椎体前缘所致,1椎系沿椎旁静脉充盈所致,均未引起临床症状。术后患者背部疼痛均明显减轻或消失,神经根刺激症状消失。首例患者术后疼痛一过性加重,3d内好转、疼痛减轻,考虑与局部炎症有关。术后住院1～4d(平均1.5d)。随访时症状缓解或消失,与术后相比无明显变化。结论PVP为症状性脊椎血管瘤提供了一种较好的微创治疗方法。
Objective To investigate the clinical efficacy of percutaneous vertebroplasty (PVP) in the treatment of symptomatic spinal hemangiomas. Methods A total of 11 patients, 2 males and 9 females; aged 35 to 77 years, mean 54.3 years; both back pain and other symptoms, including 2 cases of nerve root irritation; lesions: thoracic 11, lumbar 3 ; PVP was performed on 16 vertebral bodies (including 2 osteoporotic compression fractures) under DSA or CT monitoring. Postoperative CT examination. Follow up for 3 to 34 months (average 15.2 months). Results No complications such as pulmonary embolism and nerve injury occurred in 11 patients after PVP. No post-operative intraspinal or intervertebral foramen leakage was found after CT examination. Only 2 cases of 2 vertebral paravertebral there is a small amount of leakage, a vertebral line piercing the anterior vertebral puncture caused by a vertebral pedicle filling along the paravertebral vein, did not cause clinical symptoms. Patients with back pain were significantly reduced or disappeared, nerve root irritation disappeared. The first patient had a transient postoperative pain aggravated, 3d improved, reduce pain, consider the local inflammation. Postoperative hospital 1 ~ 4d (average 1.5d). At follow-up, symptoms disappeared or disappeared, with no significant changes after operation. Conclusions PVP provides a better minimally invasive treatment for symptomatic spondylopenma.