Heffernan Eric J, O'Sullivan Paul J, Alkubaidan Fahad O, Heran Manraj K S, Legiehn Gerald M, Munk Peter L
Department of Radiology, Vancouver General Hospital University of British Columbia, Vancouver, BC.
Can Assoc Radiol J. 2008 Apr;59(2):77-82.
To provide an overview of the current status of percutaneous vertebroplasty (PVP) practice in Canada, including the preprocedure work up, operative technique and follow-up practice of physicians performing the procedure in this country.
Questionnaires were emailed to 31 institutions performing percutaneous vertebroplasty across Canada.
Twenty-three (74.2%) completed surveys were returned, representing data from 1516 vertebroplasties performed by 66 radiologists and surgeons. Preoperative routine imaging and screening practice varies widely. The majority of respondents perform PVP under conscious sedation; however, an anaesthetist is present in only 22% of institutions. Biplane fluoroscopy is used in 43.5% of practices. The preference for unipedicular or bipedicular injection varies: in 7 institutions, a unipedicular approach is used in at least 80% of cases. Patients receive a follow-up by the screening physician in 65.2% of institutions. There were 4 complications requiring treatment. Venous and intradiscal extravasation rates were 20.8% and 25.3%, respectively; however, the vast majority of these were clinically insignificant.
PVP complication rates reported in our Canadian survey compare favourably with those in the published literature. The number of PVPs performed annually in the institutions surveyed appears small, relative to the figures from the United States. The prevalence of osteoporosis and incidence of vertebral compression fractures in Canada is increasing as the population ages, and demand for PVP is likely to rise significantly in the coming years.
概述加拿大经皮椎体成形术（PVP）的开展现状，包括该国实施该手术的医生的术前检查、手术技术及随访情况。
通过电子邮件向加拿大31家开展经皮椎体成形术的机构发送调查问卷。
共收回23份（74.2%）完成的调查问卷，代表了66位放射科医生和外科医生实施的1516例椎体成形术的数据。术前常规影像学检查和筛查做法差异很大。大多数受访者在清醒镇静下进行PVP；然而，只有在22%的机构中有麻醉师在场。43.5%的手术使用双平面荧光透视。单椎弓根或双椎弓根注射的偏好各不相同：在7家机构中，至少80%的病例采用单椎弓根入路。65.2%的机构中患者由筛查医生进行随访。有4例并发症需要治疗。静脉和椎间盘内渗漏率分别为20.8%和25.3%；然而，其中绝大多数在临床上无显著意义。
我们加拿大调查中报告的PVP并发症发生率与已发表文献中的数据相比具有优势。相对于美国的数据，接受调查的机构每年实施的PVP数量似乎较少。随着加拿大人口老龄化，骨质疏松症的患病率和椎体压缩骨折的发生率正在上升，未来几年对PVP的需求可能会大幅增加。
