经皮椎体成行与后凸成行术并发症原因分析.docVIP

经皮椎体成行与后凸成行术并发症原因分析 　　 【摘要】目的:探讨经皮椎体成行和后凸成行术并发症的原因与预防策略。方法 回顾2008年3月至2011年8月经皮穿刺椎体成形技术和后凸成行术治疗62例81个椎体，分析并发症发生的原因。结果 6发生了不同程度的并发症，27例(33.3% )发生了不同程度的骨水泥渗漏，其中15 例渗漏到前纵韧带下及周围，无明显大血管侵蚀症状；6例渗漏到椎间盘；3 例沿椎旁静脉扩散至上及下位椎体周围，无明显神经症状；1 例渗漏入椎管内，无急性脊髓压迫症状；1 例渗漏到神经根管周围； 1 例肺内见点状骨水泥渗漏，无明显呼吸症状。 结论 加强围手术期管理，严格正规的操作技术是预防并发症、减少骨水泥渗漏的有效方法。 　　【关键词】骨水泥；经皮椎体成形术和经皮椎体后凸成形术；渗漏 　　【中国分类号】R687【文献标识码】A【文章编号】1044-5511（2011）11-0403-02 　　 　　【Analysis】the complications and bone cement leakage in the percutaneous vertebroplasty and percutaneous kyphoplasty ABSTRACT OBJECTIVE: To explore the reason of complication after percutaneous vertebroplasty(PVP) or percutaneous kyphoplasty(PKP)，and how to prevent beforehand. METHODS: To review 81 centrums of 62 cases were treated with PVP or PKP and analyze the reason of complication and bone cement leakage. RESULTS: A total of 6 cases with different complication . A total of 27 cases (33．3% ) with bone cement leakage in surgery, including 15 cases exhibited leakage under and around the anterior longitudinal ligament, without significant symptoms of major vascular erosion. 6 cases of leakage to intervertebral discs. 3 cases of leakage along the paravertebral vein spread from around the first and lower vertebral, there was no neurological symptom.1 cases of leakage in the spinal canal, without symptoms of acute spinal cord compression. 1 cases exhibit leakage around the nerve root canal. 1 case showed pulmonary punctate cement leakage, with no significant respiratory symptoms. CONCLUSION: To strengthen management of pro-operation and post-operation in clinical work and elevate surgical operation technique can reduce the incidences of bone cement leakage and prevent complications. 　　【key words】bone cement percutaneous, vertebroplasty and percutaneous kyphoplasty, leakage 　　 　　近年来，行经皮椎体成形术（percutaneous vertebroplasty PVP)与经皮椎体后凸成形术percutaneous kyphoplasty(PKP)进行椎体强化治疗老年性骨质疏松性椎体骨折、椎体血管瘤、椎体骨髓瘤及各种椎体转移瘤等方面取得了满意的效果，可显著消除或减轻疼痛，明显提高患者的生活质量，得到了广泛认可。但临床工作中出现了一些并发症和比