Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, Chastanet P, Duquesnoy B, Deramond H
Department of Skeletal Radiology, Hôpital Roger Salengro-CHRU de Lille, France.
Radiographics. 1998 Mar-Apr;18(2):311-20; discussion 320-3. doi: 10.1148/radiographics.18.2.9536480.
Vertebroplasty is an effective new radiologic procedure consisting of the percutaneous injection of a biomaterial, usually methyl methacrylate, into a lesion of a vertebral body. This technique allows marked or complete pain relief and bone strengthening in most cases. The principal indications for vertebroplasty are osteolytic metastasis and myeloma, painful or aggressive hemangioma, and osteoporotic vertebral collapse with debilitating pain that persists despite correct medical treatment. Radiography and computed tomography must be performed in the days preceding vertebroplasty to assess the extent of vertebral collapse, the location and extent of the lytic process, the visibility and degree of involvement of the pedicles, the presence of cortical destruction or fracture, and the presence of epidural or foraminal stenosis caused by tumor extension or bone fragment retropulsion. Leakage of methyl methacrylate during vertebroplasty may cause compression of adjacent structures and necessitate emergency decompressive surgery; thus, the procedure should be performed only in a surgical center. The decision to perform vertebroplasty should be made by a multidisciplinary team because the choice between vertebroplasty, surgery, radiation therapy, medical treatment, or a combination thereof depends on a number of factors. Radiologists need to be aware of the various indications for vertebroplasty and of potential future developments and applications of the procedure.
椎体成形术是一种有效的新型放射学治疗方法，通过经皮向椎体病变部位注射一种生物材料（通常为甲基丙烯酸甲酯）来实现。在大多数情况下，该技术可显著缓解疼痛或完全止痛，并增强骨骼强度。椎体成形术的主要适应证包括溶骨性转移瘤和骨髓瘤、疼痛性或侵袭性血管瘤，以及经适当药物治疗后仍持续存在严重疼痛的骨质疏松性椎体压缩骨折。在椎体成形术前数天必须进行X线摄影和计算机断层扫描，以评估椎体塌陷的程度、溶骨性病变的位置和范围、椎弓根的显影情况及受累程度、皮质骨破坏或骨折的情况，以及肿瘤扩展或骨碎片后移导致的硬膜外或椎间孔狭窄情况。椎体成形术中甲基丙烯酸甲酯渗漏可能会压迫相邻结构，需要进行紧急减压手术；因此，该手术应仅在手术中心进行。椎体成形术的决策应由多学科团队做出，因为在椎体成形术、手术、放射治疗、药物治疗或联合治疗之间做出选择取决于多种因素。放射科医生需要了解椎体成形术的各种适应证以及该手术未来可能的发展和应用。
