Chung Seung-Eun, Lee Sang-Ho, Kim Tae-Hong, Yoo Kwang Hyun, Jo Byung-June
Department of Diagnostic Radiology, Wooridul Spine Hospital, Seoul, Republic of Korea.
Eur Spine J. 2006 Oct;15 Suppl 5(Suppl 5):590-4. doi: 10.1007/s00586-005-0037-0. Epub 2005 Dec 14.
Percutaneous vertebroplasty (PVP) is an effective treatment for lesions of the vertebral body that involves a percutaneous injection of polymethylmethacrylate (PMMA). Although PVP is considered to be minimally invasive, complications can occur during the procedure. We encountered a renal embolism of PMMA in a 57-year-old man that occurred during PVP. This rare case of PMMA leakage occurred outside of the anterior cortical fracture site of the L1 vertebral body, and multiple tubular bone cements migrated to the course of the renal vessels via the valveless collateral venous network surrounding the L1 body. Although the authors could not explain the exact cause of the renal cement embolism, we believe that physicians should be aware of the fracture pattern, anatomy of the vertebral venous system, and careful fluoroscopic monitoring to minimize the risks during the PVP.
经皮椎体成形术(PVP)是一种治疗椎体病变的有效方法,该方法涉及经皮注射聚甲基丙烯酸甲酯(PMMA)。尽管PVP被认为是微创治疗,但在手术过程中仍可能发生并发症。我们遇到一例57岁男性在PVP手术过程中发生PMMA肾栓塞的病例。这例罕见的PMMA渗漏发生在L1椎体前皮质骨折部位之外,多个管状骨水泥通过L1椎体周围无瓣膜的侧支静脉网络迁移至肾血管走行处。尽管作者无法解释肾水泥栓塞的确切原因,但我们认为医生应了解骨折类型、椎体静脉系统的解剖结构,并在荧光透视下仔细监测,以尽量降低PVP手术期间的风险。