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经皮血管成形术治疗椎体骨质疏松性压缩骨折

Percutaneous Vesselplasty for the Treatment of Vertebral Osteoporotic Collapse Fractures.

作者信息

Agrawal Prachita, Banode Pankaj, Nagendra Vadlamudi, Joshi Raj, Agrawal Shubham, John Jubin, Nawale Neha

机构信息

Interventional Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Interventional Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research,Wardha, Wardha, IND.

出版信息

Cureus. 2024 Sep 5;16(9):e68695. doi: 10.7759/cureus.68695. eCollection 2024 Sep.

Abstract

A 78-year-old woman with vertebral compression fractures (VCFs) and chronic back pain was the subject of this case study. To treat symptomatic VCFs, less invasive procedures such as balloon kyphoplasty and vertebroplasty were developed. Vertebroplasty involves injecting polymethylmethacrylate (PMMA) into the vertebral body to mechanically stabilize it. However, there was a risk that PMMA could leak, potentially causing a pulmonary embolism or neurological problems. A modified vertebroplasty called balloon kyphoplasty reduced the chance of leakage but was not without complications. It used a high-pressure balloon to create a cavity before cement injection. An alternative procedure, called vesselplasty, aimed to reduce bone filler leakage, minimize void formation, and restore vertebral height. When vesselplasty was introduced, bone cement was held in place by a polyethylene terephthalate (PET) balloon container that expanded inside the vertebral body to lower the risk of leakage. Vesselplasty was shown to be a more secure and successful treatment for VCFs, especially in osteoporotic patients with peripheral wall injury. Vesselplasty was a potentially effective treatment for osteoporotic VCF patients in correcting kyphosis, restoring vertebral height, and reducing pain. During a six-month follow-up period, post-operative examinations following vesselplasty demonstrated considerable pain reduction, improved vertebral height, and superior overall health outcomes.

摘要

一名患有椎体压缩性骨折(VCF)和慢性背痛的78岁女性是本病例研究的对象。为了治疗有症状的VCF,人们开发了诸如球囊后凸成形术和椎体成形术等侵入性较小的手术。椎体成形术包括将聚甲基丙烯酸甲酯(PMMA)注入椎体以实现机械稳定。然而,存在PMMA渗漏的风险,这可能会导致肺栓塞或神经问题。一种名为球囊后凸成形术的改良椎体成形术降低了渗漏的几率,但也并非没有并发症。它在注入骨水泥之前使用高压球囊来制造一个空腔。另一种手术,称为血管成形术,旨在减少骨填充剂渗漏、使空隙形成最小化并恢复椎体高度。当引入血管成形术时,骨水泥由一个聚对苯二甲酸乙二酯(PET)球囊容器固定在适当位置,该容器在椎体内膨胀以降低渗漏风险。血管成形术被证明是一种治疗VCF更安全、更成功的方法,特别是对于伴有外周壁损伤的骨质疏松患者。血管成形术对于骨质疏松性VCF患者在矫正后凸畸形、恢复椎体高度和减轻疼痛方面是一种潜在有效的治疗方法。在为期六个月的随访期内,血管成形术后的术后检查显示疼痛明显减轻、椎体高度改善且总体健康结果更佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ef/11452920/ddfc2a17cf52/cureus-0016-00000068695-i01.jpg

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