Ortiz A Orlando, Brook Allan L
Department of Radiology, Winthrop-University Hospital, Mineola, New York, and Stony Brook University School of Medicine, Stony Brook, NY, USA.
Tech Vasc Interv Radiol. 2009 Mar;12(1):51-63. doi: 10.1053/j.tvir.2009.06.006.
Sacral vertebroplasty, or sacroplasty, entails the percutaneous insertion of 1 or more bone needles into the sacral ala and, less commonly, the sacral vertebra with fluoroscopic and/or computed tomographic guidance. Acrylic bone cement is then injected under imaging guidance to treat the lesion and stabilize the sacrum. Sacroplasty is indicated for the treatment of painful sacral insufficiency fractures and painful sacral masses, both of which destabilize the sacrum. In properly selected patients, sacroplasty is an extremely efficacious procedure with a low-risk profile when performed with meticulous imaging guidance and a thorough appreciation of the complex sacral anatomy. Complete pain relief is observed in the overwhelming majority of patients that are treated for sacral insufficiency fractures. While the success rate is lower in patients with painful sacral neoplastic lesions, many of these patients experience a reduction in analgesic use and a return to ambulation.
骶骨椎体成形术,即骶骨成形术,需要在荧光镜和/或计算机断层扫描引导下经皮将1根或多根骨针插入骶骨翼,较少情况下插入骶椎。然后在影像引导下注入丙烯酸骨水泥以治疗病变并稳定骶骨。骶骨成形术适用于治疗引起疼痛的骶骨不全性骨折和引起疼痛的骶骨肿物,这两种情况都会使骶骨不稳定。在经过适当选择的患者中,当在细致的影像引导下并充分了解复杂的骶骨解剖结构时,骶骨成形术是一种极其有效的手术,风险较低。绝大多数接受骶骨不全性骨折治疗的患者疼痛完全缓解。虽然患有引起疼痛的骶骨肿瘤性病变的患者成功率较低,但这些患者中有许多人止痛药用量减少并恢复了行走能力。