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经皮骨水泥成形术

Percutaneous cementoplasty.

作者信息

Katsanos Konstantinos, Sabharwal Tarun, Adam Andreas

机构信息

Department of Interventional Radiology, Guy's and St. Thomas' Hospital, NHS Foundation Trust, London, United Kingdom.

出版信息

Semin Intervent Radiol. 2010 Jun;27(2):137-47. doi: 10.1055/s-0030-1253512.

Abstract

Cementoplasty includes percutaneous procedures like vertebroplasty, kyphoplasty, osteoplasty, and sacroplasty. Bone packing with cement aims to treat or prevent vertebral and extraspinal pathological fractures and relieve pain in patients with osteoporosis and bone metastases. The authors outline the accepted and newer indications for patient selection and present the fundamentals of image-guided lesion access and cement injection. Practitioners should evaluate each patient carefully and have a thorough knowledge of the anatomy, the technique, the expected outcomes, and the potential complications. Detailed informed consent and multidisciplinary decision making are recommended. Understanding of the particular advantages and limitations of the various modern filler materials is also crucial for a successful and uncomplicated procedure. Future developments include new mechanical devices for effective restoration of vertebral height, as well as the introduction of osteoconductive and osteoinductive cements that will be able to promote more physiological bone healing.

摘要

骨水泥成形术包括诸如椎体成形术、后凸成形术、骨成形术和骶骨成形术等经皮手术。用骨水泥进行骨填充旨在治疗或预防椎体及脊柱外病理性骨折,并缓解骨质疏松症和骨转移患者的疼痛。作者概述了公认的和新的患者选择适应证,并介绍了影像引导下病变穿刺和骨水泥注射的基本原理。从业者应仔细评估每位患者,并全面了解解剖结构、技术、预期结果和潜在并发症。建议进行详细的知情同意和多学科决策。了解各种现代填充材料的特殊优点和局限性对于成功且无并发症的手术也至关重要。未来的发展包括用于有效恢复椎体高度的新型机械设备,以及能够促进更生理性骨愈合的骨传导性和骨诱导性骨水泥的引入。

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本文引用的文献

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Randomized vertebroplasty trials: bad news or sham news?随机椎体成形术试验:坏消息还是虚假消息?
AJNR Am J Neuroradiol. 2009 Nov;30(10):1808-9. doi: 10.3174/ajnr.A1875. Epub 2009 Oct 8.
2
Vertebroplasty, research design, and critical analysis.椎体成形术、研究设计与批判性分析。
J Vasc Interv Radiol. 2009 Oct;20(10):1277-8. doi: 10.1016/j.jvir.2009.08.017.
3
Effectiveness of vertebroplasty: a recent controversy.椎体成形术的有效性:近期的争议。
Can Assoc Radiol J. 2009 Oct;60(4):170-1. doi: 10.1016/j.carj.2009.08.001.
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Image-guided ablation therapy of bone tumors.骨肿瘤的图像引导消融治疗。
Semin Ultrasound CT MR. 2009 Apr;30(2):78-90. doi: 10.1053/j.sult.2008.12.003.

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