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-  2017 

经皮脊柱内镜治疗经皮椎体成形术后骨水泥椎管内渗漏的疗效观察

DOI: doi:10.7507/1002-1892.201612139

Keywords: 经皮脊柱内镜技术, 经皮椎体成形术, 骨水泥椎管内渗漏, 脊髓损伤

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Abstract:

目的 探讨采用经皮脊柱内镜治疗经皮椎体成形术(percutaneous vertebroplasty,PVP)后骨水泥椎管内渗漏的可行性及安全性。 方法 2014 年 5 月—2016 年 3 月,应用经皮脊柱内镜下椎管内骨水泥取出减压术治疗 5 例 PVP 术后骨水泥椎管内渗漏致脊髓神经损伤患者。其中,男 3 例,女 2 例;年龄 65~83 岁,平均 74.4 岁;PVP 术后至该次入院时间为 10~30 d,平均 16.2 d。骨水泥渗漏节段:T 12、L 1 3 例,L 1、2 2 例;双侧渗漏 1 例,单侧渗漏 4 例。主要临床症状为下肢疼痛 2 例,疼痛视觉模拟评分(VAS)分别为 8 分及 7 分;下肢肌力减退 3 例,日本骨科协会(JOA)29 评分分别为 18、20、19 分。5 例神经功能根据美国脊髓损伤协会(ASIA)损伤分级为 E 级 2 例,D 级 3 例。 结果 手术时间 55~119 min,平均 85.6 min。术中出血量 30~80 mL,平均 48 mL。术后第 1 天影像学检查均示骨水泥均全部取出。5 例患者均获得随访,随访时间 6~21 个月,平均 12 个月。其中,2 例术前临床症状以下肢疼痛为主患者,末次随访时 VAS 评分均为 2 分;3 例术前临床症状以下肢肌力减退为主患者,下肢肌力逐渐恢复,末次随访 JOA29 评分分别为 21、23、22 分。 结论 经皮脊柱内镜技术治疗 PVP 术后骨水泥椎管内渗漏安全、可行

References

[1]  1. Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie, 1987, 33(2): 166-168.
[2]  3. Bonnard E, Foti P, Kastler A, et al. Percutaneous vertebroplasty under local anaesthesia: feasibility regarding patients’ experience. Eur Radiol, 2017, 27(4): 1512-1516.
[3]  10. Al-Nakshabandi NA. Percutaneous vertebroplasty complications. Ann Saudi Med, 2013, 31(3): 294-297.
[4]  11. Fehlings MG, Perrin RG. The timing of surgical intervention in the treatment of spinal cord injury: a systematic review of recent clinical evidence. Spine (Phlia Pa 1976), 2006, 31(11 Suppl): S28-35.
[5]  16. 施建党, 白雷, 丁惠强, 等. 不同术式治疗陈旧性胸腰椎骨折并脊髓损伤的疗效比较. 中国修复重建外科杂志, 2008, 22(11): 1327-1329.
[6]  18. Ruetten S, Komp M, Merk H, et al. Recurrent lumbar disc herniation after conventional discectomy: a prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision. J Spinal Disord Tech, 2009, 22(2): 122-129.
[7]  20. Li ZZ, Hou SX, Shang WL, et al. Percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decom-pression for lateral recess stenosis through transforaminal approach: Technique notes and 2 years follow-up. Clin Neurol Neurosurg, 2016, 143: 90-94.
[8]  6. Nieuwenhuijse MJ, Van Erkel AR, Dijkstra PD. Cement leakage in percutaneous vertebroplasty for osteoporotic vertebral compression fractures: identification of risk factors. Spine J, 2011, 11(9): 839-848.
[9]  7. Tomé-Bermejo F, Pi?era AR, Duran-álvarez C, et al. Identification of Risk Factors for the Occurrence of Cement Leakage During Percutaneous Vertebroplasty for Painful Osteoporotic or Malignant Vertebral Fracture. Spine, 2013, 9(Supplement): S90.
[10]  15. Lin BJ, Li CC, Ma HI. Intradural Cement Leakage After Percutaneous Vertebroplasty. Turk Neurosurg, 2015, 25(6): 940-942.
[11]  17. Wu AM, Zheng YJ, Lin Y, et al. Transforaminal decompression and interbody fusion in the treatment of thoracolumbar fracture and dislocation with spinal cord injury. PloS One, 2014, 9(8): e105625.
[12]  19. Ahn Y. Percutaneous endoscopic decompression for lumbar spinal stenosis. Expert Rev Med Devices, 2014, 11(6): 605-616.
[13]  21. Yeom JS, Kim WJ, Choy WS, et al. Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteo-porotic compression fractures. J Bone Joint Surg (Br), 2003, 85(1): 83-89.
[14]  22. Ahn SS, Kim SH, Kim DW. Learning Curve of Percutaneous Endoscopic Lumbar Discectomy Based on the Period (Early vs. Late) and Technique (in-and-out vs. in-and-out-and-in): A Retrospective Comparative Study. J Korean Neurosurg Soc, 2015, 58(6): 539-546.
[15]  2. Burton AW, Mendoza T, Gebhardt R, et al. Vertebral compression fracture treatment with vertebroplasty and kyphoplasty: experience in 407 patients with 1,156 fractures in a tertiary cancer center. Pain Med, 2011, 12(12): 1750-1757.
[16]  4. La Maida GA, Giarratana LS, Acerbi A, et al. Cement leakage: safety of minimally invasive surgical techniques in the treatment of multiple myeloma vertebral lesions. Eur Spine J, 2012, 21 Suppl 1: S61-S68.
[17]  5. Corcos G, Dbjay J, Mastier C, et al. Cement leakage in percutaneous vertebroplasty for spinal metastases: a retrospective evaluation of incidence and risk factors. Spine (Phlia Pa 1976), 2014, 39(5): E332-E338.
[18]  8. Saracen A, Kotwica Z. Complications of percutaneous vertebroplasty: An analysis of 1100 procedures performed in 616 patients. Medicine (Baltimore), 2016, 95(24): e3850.
[19]  9. Kulkarni AG, Shah SP, Deopujari CE. Epidural and intradural cement leakage following percutaneous vertebroplasty: a case report. J Orthop Surg (Hong Kong), 2013, 21(3): 365-368.
[20]  12. Vaccaro AR, Daugherty RJ, Sheehan TP, et al. Neurologic outcome of early versus late surgery for cervical spinal cord injury. Spine (Phlia Pa 1976), 1997, 22(22): 2609-2613.
[21]  13. 周方. 胸腰椎骨折伴完全性脊髓损伤的手术时机选择. 中华创伤杂志, 2015, 31(6): 490.
[22]  14. Fehlings MG, Perrin RG. The role and timing of early decompression for cervical spinal cord injury: update with a review of recent clinical evidence. Injury, 2005, 36 Suppl 2: B13-26.

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