摘要
目的分析和探讨经皮穿刺椎体成形术(percutaneous vertebraplasty,PVP)治疗骨质疏松性椎体压缩骨折导致骨水泥渗漏的原因。方法回顾性分析2011年3月-2014年2月在我科行经皮穿刺椎体成形术的105例(146个椎体)患者,术后行X线及CT检查,观察骨水泥渗漏情况,并分析渗漏原因。结果本组中47例(63个椎体)发生了骨水泥渗漏,渗漏率为43.15%。其中椎管内渗漏4例,神经孔渗漏4例,椎间盘渗漏8例,椎体周围渗漏10例,椎体前缘静脉渗漏7例,针道通路渗漏14例。15例因进针方向不准确引起,13例因反复穿刺致使椎弓根骨皮质破损引起,9例因骨水泥注入时机不恰当引起,7例因骨水泥注入量过多引起,3例因影像设备显影不清晰引起。结论骨水泥渗漏是PVP的常见并发症,本研究表明,进针方向不准确、反复穿刺、骨水泥注入时机不恰当、骨水泥注入量过多、影像设备显影不清为引起骨水泥渗漏的主要原因。
Objective To analyze and explore the causes of bone cement leakage in percutaneous vertebroplasty （PVP）.Methods Clinical data about 105 （146 vertebrae） patients who were treated by percutaneous vertebroplasty in our department from March 2011 to February 2014 were retrospectively analyzed.Postoperative X-ray and CT examination were performed in order to observe the bone cement leakage and analyze the related causes.Results The bone cement leaked in 47 （63 vertebrae） patients with 4 cases in vertebral canal,4 cases in neural foramen,8 cases in intervertebral disk,10 cases on the side of the vertebrae,7 cases in veins and the other 14 cases at the site of the puncture,and the rate of leakage was 43.15％.The main reasons of the bone cement leakage were inaccurate needle direction in 15 cases,repeated puncture in 13 cases,inappropriate time of bone cement injection in 9 cases,excessive amount of bone cement injection in 7 cases,and unclear imaging equipment in 3 cases.Conclusion Cement leakage is a common complication of PVP.This study shows that the main reasons of the bone cement leakage are inaccurate needle direction,repeated puncture,inappropriate time of bone cement injection,excessive amount of bone cement injection,and unclear imaging equipment.
出处
《解放军医学院学报》
CAS
2014年第11期1093-1096,共4页
Academic Journal of Chinese PLA Medical School
基金
国家自然科学基金项目(51372276)~~
关键词
经皮穿刺椎体成形术
骨水泥渗漏
原因
预防
percutaneous vertebraplasty
bone cement leakage
reasons
prevention
