ct导引下椎体成形术在胸腰段椎体压缩性病变治疗中的临床应用

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1、CT导引下椎体成形术在胸腰段椎体压缩性病变治疗中的临床应用作者：贺玉玺王小平索文华【摘要】目的：探讨椎体成形术在治疗胸11-腰3椎体压缩性病变的应用及临床治疗效果。方法：经DR、CT、MRI检查，结合临床表现、病史明确诊断18例椎体压缩性病变，共涉及20个椎体，应用椎体成形术治疗。在CT导引下注入骨水泥，术中行CT扫描观察骨水泥注入量及椎体膨胀情况，临床观察患者疗效及并发症情况。结果：CT导引下经皮穿刺椎体成形术操作成功，经临床1～18个月不定期随访，16例患者在术后1个月内疼痛症状完全缓解；1例患者在术后时有神经根刺激症状，用药后症状可以

2、改善，3个月复查症状完全缓解；1例患者手术前后症状未见明显变化；所有患者未出现严重并发症。术后1个月、3个月对病变行CT椎体扫描，18个椎体明显饱满扩大，骨水泥涵于椎体内；2个椎体外形轻度变化，骨水泥外溢于椎旁间隙。结论：CT定位导引下经皮穿刺椎体成形术，路径设计合理，穿刺成功率高，避免多次重复穿刺，所以创伤小、并发症少；有效地解除了由于椎体压缩性病变而引起的多种临床症状。【关键词】CT扫描；椎体成形术；椎体压缩；骨水泥　　AbstractObject:Toevaluatetheclinicalapplicationas9wellasits

3、therapeuticeffectsofpercutaneousvertebroplasty(PVP)inthetreatmentofvertebralcompressiondamagebetweenthoracicvertebraeT11tolumbarvertebraeL3.Methods:ThroughfollowingexaminationsuchasCTscanning,DRandMRI,alongwithevaluationofclinicalsymptomsandmedicalhistory,18casesofvertebra

4、lcompressiondamagehavebeendiagnosedwithcertaintyandPVPoperationwasadoptedforthetreatmentofthe20vertebraeaffected.BonecementwasinjectedunderCTguidance.TheinjectionamountandthecorrespondingexpansioninthevertebralbodyinjectedwerealsocarefullymonitoredwithCTscanningduringPVPop

5、eration.Thetherapeuticeffectsaswellasanypossiblecomplicationwereevaluatedafterwards.Results:18CT-guidedPVPoperationswereallsuccessfullyperformed.Afterfollow-upvisittoallthepatientsduringatimeperiodrangingfrom1to18months,ithasbeenfoundthatasmanyas16patientsexhibitcompletere

6、liefofpainsymptomswithinasshortas1monthafteroperation;1patientexhibitsirritatingsymptomsrelatedtonerveroot,whichwasalleviateduponmedicineadministrationandcompletelyrelieved3monthslater.Only1patientexhibitsnosignificantimprovementinpainsymptomsafterPVP.Noclinicallysignifica

7、ntcomplicationwasfoundinallpatients.CTfollow-upevaluationofpreviously9damagedvertebralbodieswascarriedouttwiceatthetimepoint1monthand3monthafterPVP,respectively.Theresultsshowthat18vertebralbodieswereobviouslyenlargedandplumpinappearanceduetoaccumulationofbonecementinjecte

8、dwithinand2othervertebralbodieswereslightlydeformedwithbonecementleakingintoparavertebral