男性椎体成形术的治疗考量
Treatment considerations for vertebroplasty in men.
作者信息
Hammond Alan, Riley Lee H, Gailloud Philippe, Nussbaum David A, Malhotra A, Watkins Monica, Murphy Kieran J
机构信息
Division of Interventional Neuroradiology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
出版信息
AJNR Am J Neuroradiol. 2004 Apr;25(4):639-41.
BACKGROUND AND PURPOSE
Vertebroplasty is now a widely accepted image-guided intervention in patients with compression fracture. The purpose of this report is to look specifically at the male population undergoing vertebroplasty and identfy the management considerations distinct to men.
METHODS
The hospital medical records and radiographic studies of 24 men treated with vertebroplasty between February 1999 and November 2000 were retrospectively reviewed.
RESULTS
Five patients presented with idiopathic or secondary osteoporosis. In two of these five men, malignancies were discovered by core biopsies taken at the time of vertebroplasty. Thirteen patients (54%) had secondary osteoporosis. Of this group, 10 patients (42%) were steroid dependent and three (13%) were hypogonadal. Five patients (21%) had traumatic events leading to fracture. One presented with known metastases.
CONCLUSION
Primary osteoporosis in men is unusual. In male patients without a definable cause of osteoporosis, known metastatic disease, or a significant history of trauma, the routine performance of a vertebral biopsy through the vertebroplasty needle before the injection of bone cement is indicated to identify unexpected neoplasm.
背景与目的
椎体成形术目前是治疗压缩性骨折患者广泛接受的影像引导下的干预措施。本报告的目的是专门研究接受椎体成形术的男性人群，并确定男性特有的管理注意事项。
方法
回顾性分析1999年2月至2000年11月期间接受椎体成形术治疗的24名男性患者的医院病历和影像学研究。
结果
5例患者患有特发性或继发性骨质疏松症。在这5名男性中的2名中，在椎体成形术时进行的核心活检发现了恶性肿瘤。13例患者（54%）患有继发性骨质疏松症。在这组患者中，10例患者（42%）依赖类固醇，3例（13%）性腺功能减退。5例患者（21%）有导致骨折的创伤事件。1例患有已知转移瘤。
结论
男性原发性骨质疏松症并不常见。在没有明确骨质疏松病因、已知转移性疾病或重大创伤史的男性患者中，在注射骨水泥前通过椎体成形术针进行椎体活检以识别意外肿瘤是必要的。
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