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经皮注射羟磷灰石骨水泥治疗脊柱动脉瘤样骨囊肿。

Treatment of Spinal Aneurysmal Bone Cyst with Percutaneous Injection of Hydroxyapatite Osteoconductive Cement.

机构信息

Faculty of Medicine, The University of Campania Luigi Vanvitelli, Caserta, Italy.

Diagnostic and Interventional Neuroradiology Unit, A.O.R.N. Cardarelli, Naples, Italy.

出版信息

Cardiovasc Intervent Radiol. 2023 Dec;46(12):1726-1731. doi: 10.1007/s00270-023-03606-8. Epub 2023 Nov 17.

Abstract

PURPOSE

The aim of this study was to evaluate treatment efficacy of percutaneous injection of hydroxyapatite-osteoconductive-cement in patients with spinal aneurysmal bone cysts.

MATERIALS AND METHODS

The study was designed as a retrospective observational clinical study. We included patients who were diagnosed with of spinal aneurysmal bone cyst, at our institution between 2013 and 2020, and treated with percutaneous injection of osteoconductive cement: "Cerament" (BONESUPPORT AB, Lund, Sweden). Typical clinical and radiological features of the ABCs treatment and follow-up were investigated.

RESULTS

Our study included nine patients, two children and seven adults. Three different types of approaches were applied: (single pedicle approach in 3 patients; double pedicle approach in 2 patients; while in the remaining cases, a multiple access approach was used. VAS score decreased from 8.5 ± 0.5 before treatment to 4.1 ± 0.9 at 6-months-follow up. All of the patients reacted well to treatment, with none neurological complications, complete loss of pain and achieved osteosclerosis as radiological marker of treatment success.

CONCLUSION

Treatment of symptomatic spinal ABC's with hydroxyapatite cement is effective to achieve complete pain reduction and sclerosis.

摘要

目的

本研究旨在评估经皮注射羟磷灰石-骨传导性水泥治疗脊柱动脉瘤样骨囊肿患者的疗效。

材料和方法

本研究设计为回顾性观察性临床研究。我们纳入了 2013 年至 2020 年间在我院诊断为脊柱动脉瘤样骨囊肿并接受骨传导性水泥(“Cerament”,BONESUPPORT AB,Lund,瑞典)经皮注射治疗的患者。研究调查了 ABC 治疗和随访的典型临床和影像学特征。

结果

我们的研究纳入了 9 名患者,2 名儿童和 7 名成人。应用了三种不同的入路方式:(3 名患者采用单一椎弓根入路;2 名患者采用双椎弓根入路;而在其余病例中,采用了多途径入路。VAS 评分从治疗前的 8.5±0.5 降至 6 个月随访时的 4.1±0.9。所有患者均对治疗反应良好,无神经并发症,完全缓解疼痛,并实现了影像学上治疗成功的骨硬化标志物。

结论

用羟磷灰石水泥治疗有症状的脊柱 ABC 可有效减轻疼痛并实现骨硬化。

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