NeuroInterventional Spine Service, Massachusetts General Hospital, Boston, Massachusetts, USA.
Interventional Musculoskeletal Radiology, Clinical Radiology of Oklahoma, Edmond, Oklahoma, USA.
J Neurointerv Surg. 2019 Sep;11(9):e7. doi: 10.1136/neurintsurg-2017-013548.rep. Epub 2018 Feb 14.
A 71-year-old man who had a L1/S1 posterior fusion revision surgery complained of increasing back pain 5 weeks after the open surgical procedure. The pain was initially estimated at 9/10 on the visual analog scale (VAS) and thought to be related to a right-sided L2 screw loosening. A right parapedicular vertebroplasty was performed and polymethylmethacrylate cement was instilled around the right pedicle screw, filling the anterior two-thirds of the vertebral body. On postvertebroplasty day 1, the patient had significant improvement in his low back pain. The pain further decreased at 1 and 3 months after the intervention (2/10 on the VAS). Vertebroplasty is a minimally invasive, accessible, effective, and long lasting treatment for compression fractures. We believe that this technique could also be indicated to treat pain related to low grade screw loosening in properly selected patients.
一位 71 岁男性，曾行 L1/S1 后路融合翻修手术，在开放式手术 5 周后主诉腰痛加重。疼痛最初估计为视觉模拟评分（VAS）的 9/10，并认为与右侧 L2 螺钉松动有关。行右侧经椎弓根椎体成形术，将聚甲基丙烯酸甲酯骨水泥注入右侧椎弓根周围，填充椎体前 2/3。在椎体成形术后第 1 天，患者的腰痛显著改善。干预后 1 个月和 3 个月时疼痛进一步减轻（VAS 评分为 2/10）。椎体成形术是一种微创、可及、有效且持久的治疗压缩性骨折的方法。我们认为，对于适当选择的患者，该技术也可用于治疗与低等级螺钉松动相关的疼痛。
