Jin Peng, Liu Xunwei, Li Min, Sun Gang
Department of Medical Imaging, Jinan Military General Hospital, Shandong, P.R. China.
Clin Spine Surg. 2017 Apr;30(3):E305-E309. doi: 10.1097/BSD.0000000000000028.
A retrospective study.
Cement leakage is a frequent occurrence in vertebroplasty and is also the main source of complications. Continuous radiographic evaluation is mandatory to detect cement leakage during injecting cement into the vertebral body, while the operator is subjected to x-ray radiation exposure.
The aim of this study was to evaluate the feasibility and safety of vertebroplasty performed on patients and operators for the treatment of osteoporotic and malignant vertebral compression fractures using a remote control injection system.
Institutional review board approval was obtained for this retrospective study. Clinical charts and postoperative radiographs were obtained for 74 patients (114 levels) who underwent vertebroplasty. The study group included 46 cases (71 levels) of benign osteoporotic fractures and 28 cases (43 levels) of different malignant metastatic lesions. Under fluoroscopic guidance, cement was injected using a remote control injection system, while the operator was standing outside the radiation field. The location and degree of leakage at each treated level were recorded.
Cement leakage rate reached 47.4% across all treated levels. No severe leakage in any location was observed. A total of 35 leakages were detected in 71 levels and 24 leakages were detected in 43 levels in the benign and malignant fracture group, respectively. The overall rate of cement leakages and the location of the leakages were not statistically different between the benign and malignant fracture group (P=0.60, P=0.45). With the operator standing outside the radiation field to inject cement, the radiation dose to operators was avoided during cement injection.
Vertebroplasty using a remote control injection system was feasible and safe in treatment of osteoporotic and malignant compression fractures. The cement injection system had potential benefits to decrease the leakage rate in treating malignant fractures and eliminate injection dose to operators under lateral fluoroscopic monitoring.
一项回顾性研究。
骨水泥渗漏在椎体成形术中经常发生，也是并发症的主要来源。在向椎体注入骨水泥时，必须进行连续的影像学评估以检测骨水泥渗漏，而操作人员会受到X射线辐射暴露。
本研究的目的是评估使用遥控注射系统对患者和操作人员进行椎体成形术治疗骨质疏松性和恶性椎体压缩骨折的可行性和安全性。
本回顾性研究获得了机构审查委员会的批准。获取了74例行椎体成形术患者（114个椎体节段）的临床病历和术后X线片。研究组包括46例（71个椎体节段）良性骨质疏松性骨折和28例（43个椎体节段）不同的恶性转移病灶。在透视引导下，使用遥控注射系统注入骨水泥，操作人员站在辐射野之外。记录每个治疗椎体节段的渗漏位置和程度。
所有治疗椎体节段的骨水泥渗漏率达到47.4%。未观察到任何部位的严重渗漏。良性骨折组71个椎体节段共检测到35处渗漏，恶性骨折组43个椎体节段共检测到24处渗漏。良性和恶性骨折组的骨水泥总体渗漏率及渗漏部位无统计学差异（P = 0.60，P = 0.45）。操作人员站在辐射野之外注入骨水泥，避免了注入骨水泥过程中操作人员受到辐射剂量。
使用遥控注射系统进行椎体成形术治疗骨质疏松性和恶性压缩骨折是可行且安全的。该骨水泥注射系统在治疗恶性骨折时可能有助于降低渗漏率，并在侧位透视监测下消除对操作人员的辐射剂量。
