文豪;刘元;张柯;郭瑞;孔令擘;郝定均;贺宝荣;

• 1:西安交通大学附属红会医院

摘要(Abstract)：

椎体强化术是治疗骨质疏松性椎体压缩性骨折的有效方法,骨水泥渗漏是其最常见的并发症,其可导致血管栓塞、神经损伤及相邻椎体骨折等。随着手术适应症的选择、术中检测设备的成熟及手术技巧的使用,引起临床症状的渗漏较少见,但亦会引起截瘫、肺栓塞等致命性后果。因此,熟知各种骨水泥渗漏的临床症状,做到早期发现显得尤为重要;同时对于初学者应严格遵守手术指征,学习并掌握各种手术技巧,减少骨水泥渗漏。

关键词(KeyWords)： 椎体强化术;骨水泥渗漏;并发症;预防

Abstract:

Keywords:

基金项目(Foundation): 科技部国家重点研发计划数字诊疗装备研发项目(编号:2016YFC0105804);; 省科技厅脊髓损伤关键技术推广应用(编号:2018HJCG-08);; 西安市科技局社会发展攻关项目(编号:2017115SF/YX009)

作者(Author): 文豪;刘元;张柯;郭瑞;孔令擘;郝定均;贺宝荣;

Email:

DOI:

参考文献(References)：

• [1]Arabmotlagh M,Nikoleiski SC,Schmidt S.Radiological evaluation of kyphoplasty with an intravertebral expander after osteoporotic vertebral fracture[J].J Orthop Res,2019,37(2):457-465.
• [2]Zhao Y,Liu T,Zheng Y,et al.Successful percutaneous retrieval of a large pulmonary cement embolus caused by cement leakage during percutaneous vertebroplasty:case report and literature review[J].Spine(Phila Pa 1976),2014,39(26):E1616-E1621.
• [3]Kita K,Takata Y,Higashino K,et al.Surgical removal of circumferentially leaked polymethyl methacrylate in the epidural space of the thoracic spine after percutaneous vertebroplasty[J].Surg J(NY),2017,3(1):e1-e5.
• [4]Venmans A,Klazen C A,Lohle P N,et al.Percutaneous vertebroplasty and pulmonary cement embolism:results from VERTOS II[J].AJNR Am J Neuroradiol,2010,31(8):1451-1453.
• [5]Lin D,Hao J,Li L,et al.Effect of bone cement volume fraction on adjacent vertebral fractures after unilateral percutaneous kyphoplasty[J].Clin Spine Surg,2017,30(3):E270-E275.
• [6]Ko BS,Cho KJ,Park JW,et al.Early adjacent vertebral fractures after balloon kyphoplasty for osteoporotic vertebral compression fractures[J].Asian Spine J,2019,13(2):210-215.
• [7]Wu Y S,Zhang H,Zheng W H,et al.Hidden blood loss and the influential factors after percutaneous kyphoplasty surgery[J].Eur Spine J,2017,26(7):1878-1883.
• [8]Yeom J S,Kim W J,Choy W S,et al.Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures[J].J Bone Joint Surg Br,2003,85(1):83-89.
• [9]Jensen M E,Evans A J,Mathis J M,et al.Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures:technical aspects[J].AJNR Am J Neuroradiol,1997,18(10):1897-1904
• [10]LeeI J,Choi A L,Yie M Y,et al.CT evaluation of local leakage of bone cement after percutaneous kyphoplasty and vertebroplasty[J].Acta Radiol,2010,51(6):649-654.
• [11]La Maida G A,Giarratana L S,Acerbi A,et al.Cement leakage:safety of minimally invasive surgical techniques in the treatment of multiple myeloma vertebral lesions[J].Eur Spine J,2012,21(Suppl 1):S61-S68.
• [12]Bhatia C,Barzilay Y,Krishna M,et al.Cement leakage in percutaneous vertebroplasty:effect of preinjection gelfoam embolization[J].Spine(Phila Pa 1976),2006,31(8):915-919.
• [13]Meng B,Qian M,Xia S X,et al.Biomechanical characteristics of cement/gelatin mixture for prevention of cement leakage in vertebral augmentation[J].Eur Spine J,2013,22(10):2249-2255.
• [14]Oh JS,Doh JW,Shim JJ,et al.The effectiveness of gelfoam technique before percutaneous vertebroplasy:is it helpful for prevention of cement leakage?A prospective randomized control study[J].Korean J Spine,2016,13(2):63-66.
• [15]Ding J,Zhang Q,Zhu J,et al.Risk factors for predicting cement leakage following percutaneous vertebroplasty for osteoporotic vertebral compression fractures[J].Eur Spine J,2016,25(11):3411-3417.
• [16]Gstottner M,Angerer A,Rosiek R,et al.Quantitative volumetry of cement leakage in viscosity-controlled vertebroplasty[J].J Spinal Disord Tech,2012,25(5):E150-E154.
• [17]Lim BG,Lee JY,Lee MK,et al.Kyphoplasty for the treatment of vertebral compression fractures in a cancer patient with neurological deficits and anterior vertebral wall destruction[J].Pain Physician,2011,14(6):539-544.
• [18]Kim B S,Hum B,Park J C,et al.Retrospective review of procedural parameters and outcomes of percutaneous vertebroplasty in 673patients[J].Interv Neuroradiol,2014,20(5):564-575.
• [19]Belkoff S M,Mathis J M,Jasper L E,et al.The biomechanics of vertebroplasty.The effect of cement volume on mechanical behavior[J].Spine(Phila Pa 1976),2001,26(14):1537-1541
• [20]Nieuwenhuijse M J,Bollen L,van Erkel A R,et al.Optimal intravertebral cement volume in percutaneous vertebroplasty for painful osteoporotic vertebral compression fractures[J].Spine(Phila Pa1976),2012,37(20):1747-1755.
• [21]Feng H,Huang P,Zhang X,et al.Unilateral versus bilateral percutaneous kyphoplasty for osteoporotic vertebral compression fractures:a systematic review and meta-analysis of RCTs[J].J Orthop Res,2015,33(11):1713-1723.
• [22]Zhang L,Liu Z,Wang J,et al.Unipedicular versus bipedicular percutaneous vertebroplasty for osteoporotic vertebral compression fractures:a prospective randomized study[J].BMC Musculoskelet Disord,2015,16:145.
• [23]Yan L,Jiang R,He B,et al.A comparison between unilateral transverse process-pedicle and bilateral puncture techniques in percutaneous kyphoplasty[J].Spine(Phila Pa 1976),2014,39(26):B19-B26.
• [24]Li J,Li T,Ma Q,et al.Using side-opening injection cannulas to prevent cement leakage in percutaneous vertebroplasty for osteoporotic vertebral compression fractures,does it really work[J].J Orthop Sci,2017,22(5):811-815.
• [25]Hoppe S,Elfiky T,Keel M J,et al.Lavage prior to vertebral augmentation reduces the risk for cement leakage[J].Eur Spine J,2016,25(11):3463-3469.
• [26]Chu W,Tsuei Y C,Liao P H,et al.Decompressed percutaneous vertebroplasty:a secured bone cement delivery procedure for vertebral augmentation in osteoporotic compression fractures[J].Injury,2013,44(6):813-818.
• [27]Mohamed R,Silbermann C,Ahmari A,et al.Cement filling control and bone marrow removal in vertebral body augmentation by unipedicular aspiration technique:an experimental study using leakage model[J].Spine(Phila Pa 1976),2010,35(3):353-360.
• [28]Uri I F,Garnon J,Tsoumakidou G,et al.An ice block:a novel technique of successful prevention of cement leakage using an ice ball[J].Cardiovasc Intervent Radiol,2015,38(2):470-474.