骨水泥渗漏入椎管对脊髓神经的静态损伤分析.docVIP

骨水泥渗漏入椎管对脊髓神经的静态损伤分析 Analyzed the static damage of spinal cord in vertebroplasty after the bone cement leakage into the spinal canal 杨智贤 彭小忠 武振国 韦涵渝 雷成刚 陈明 柳州市工人医院脊柱外科 545005 Abstract: Objective: To investigate the static damage of spinal cord in vertebroplasty, after the bone cement leakage into the spinal canal. Methods: For 165 cases of elderly patients with osteoporotic compression fracture(OVCF), a total of 213 vertebral body by vertebroplasty , X-rays showed obvious leakage of bone cement into the vertebral canal, 23 vertebral body, CT scan showed 59 vertebral body, according to the inclusion criteria, 23 vertebral body with cement leakage into the spinal canal(epidural lea-kage) , were measured , counted and analyzed the CT scan film of bone cement leakage into the spin-al canal hill ,at here, the maximum area and minimum sagittal spinal canal diameter, ,the relationship between neurological symptoms in the clinical. Results: In the above observed object, there were not cause spinal cord injury, after the leakage of bone cement into the spinal canal a certain amount, patients showed negative symptoms. Conclusion: After bone cement leakage into the spinal canal a certain amount at different stages of the spinal cord, less than the critical value usually does not cause static spinal cord injury. Keywords: Laminoplasty Cement leakage Static damage 摘要：目的：探讨在椎体成形术中骨水泥渗漏入椎管后，对脊髓神经的静态损伤。方法：对老年骨质疏松性压缩骨折（Osteoporotic vertebral compressin fracture OVCF）者165例，共213椎体成形术者，X光片可见明显骨水泥渗漏入椎管者23椎，CT扫描发现渗漏者59椎，根据纳入条件，对23椎骨水泥渗漏入椎管（硬膜外渗漏）者，测量统计CT片骨水泥渗漏入椎管“山丘”处最大面积及椎管最小矢状径，与临床神经症状的关系。结果：在以上所观察对象中，骨水泥渗漏入椎管一定量，未造成脊髓神经损伤，术后均表现为阴性症状。结论：骨水泥渗漏入椎管后，在不同阶段的临界值以下，一般不会造成脊髓神经静态损伤。 关键词：椎管成形术 骨水泥渗漏 静态损伤 经皮穿刺椎体成形术已在全国广泛推广应用。目前主要用于治疗OVCF或转移性肿瘤引起的疼痛。通过注入骨水泥对压缩的椎体起到机械支撑作用，止痛有效率达90%, 但并发症方面较多，有些是致命性的或灾难性的。本文研究了自2009.10.1-2011.5.31期间完成的165例213个病变椎体成形术（PVP148例190椎体，PKP17例23椎体），骨水泥向椎管内渗漏及对脊髓神经静态损伤情况。 一. 资料： 1.：一般资料 1.1临床资料：自2009.10.1-2011.5.31期间住院病人，经Ｘ光片、ＣＴ、MRI及BMD检查确认为OVCF者165例，共213椎体