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背景:椎体成形术是治疗老年骨质疏松性椎体压缩骨折的一种较好方法,但有些并发症较为常见,其中骨水泥渗漏可导致严重的后果。目的:探讨CT引导下椎体成形术治疗骨质疏松性椎体压缩骨折骨水泥渗漏的控制策略。方法:2013年1月至2014年3月,共133例208个椎体在CT引导下行椎体成形术,统计骨水泥渗漏的数量以及手术前后腰痛VAS评分及ODI评分,比较手术前后VAS评分及ODI评分的差异。结果:208个椎体中59个椎体发生渗漏,渗漏率约为28%,无肺栓塞及肢体感觉功能障碍等并发症发生。术前VAS评分为(6.36±2.33)分,ODI评分为62.21%±18.37%,术后VAS评分为(3.58±1.96)分,ODI评分为14.43%±9.66%,与术前相比均有统计学差异(P<0.05)。结论结论:CT引导下椎体成形术可以精准穿刺,通过一些控制策略可减少CT引导下椎体成形术中骨水泥的渗漏率,且手术过程对医务人员“零”射线暴露。
BACKGROUND: Vertebroplasty is a good method for the treatment of osteoporotic vertebral compression fractures in the elderly. However, some complications are common, and cement leakage can lead to serious consequences. Objective: To investigate the control strategy of CT guided vertebroplasty in the treatment of osteoporotic vertebral compression fractures. Methods: From January 2013 to March 2014, 133 cases of 208 vertebral bodies underwent CT-guided vertebroplasty. The number of cement leakage and the VAS scores and ODI scores of lumbago before and after surgery were compared. The VAS score And ODI score differences. Results: The 59 vertebral bodies in 208 vertebral bodies had a leakage rate of about 28%. No complications such as pulmonary embolism and limb sensory dysfunction occurred. The preoperative VAS score was (6.36 ± 2.33) points, the ODI score was 62.21% ± 18.37%, the postoperative VAS score was (3.58 ± 1.96) points, the ODI score was 14.43% ± 9.66% Learning difference (P <0.05). Conclusions: CT-guided vertebroplasty can accurately puncture, and some control strategies can reduce the leakage rate of bone cement in vertebroplasty guided by CT, and the medical staff “zero ” radiation exposure.