[1]狄镇海,谭中宝,张 建,等.ＣＴ图像参考下单侧入路经皮椎体成形术的探讨[J].介入放射学杂志,2011,(07):548.
　DI Zhen-hai,TAN Zhong-bao,ZHANG Jian,et al.Percutaneous vertebroplasty via unilateral transpedicular approach guided by preoperative CT image[J].journal interventional radiology,2011,(07):548.
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2011年07期
页码:
548
栏目:
非血管介入
出版日期:
2011-07-30

文章信息/Info

Title:
Percutaneous vertebroplasty via unilateral transpedicular approach guided by preoperative CT image
作者:
狄镇海;  谭中宝;  张 建;  毛学群;  邹 容;  王庆庆
212001 江苏省镇江市，江苏大学附属医院介入放射科
Author(s):

DI Zhen-hai;  TAN Zhong-bao;  ZHANG Jian;  MAO Xue-qun;  ZOU Rong;  WANG Qing-qing.
Department of Interventional Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, China
关键词:
经皮椎体成形术;  皮肤穿刺点;  穿刺角度;  单侧椎弓根入路
分类号:
Ｒ６８１.５３
文献标志码:
A
摘要:
目的 探讨在ＣＴ图像测量进针参数参考下单侧入路行经皮椎体成形术（ＰＶＰ）的可行性及临床疗效。方法 ５１例患者（６７个椎体），在ＰＶＰ前，采用ＰＡＣＳ系统自带测量软件于ＣＴ图像上划线模拟单侧进路的可行性，以及测量经皮进针点与棘突间的距离和进针角度，在Ｘ线透视下行单侧ＰＶＰ，模拟线提示不能单侧进路者改用双侧进路。采用视觉模拟评分（ＶＡＳ）法和ＷＨＯ评分法分析疼痛缓解情况。统计学分析采用ＳＰＳＳ１３．０，计量数据采用配对ｔ检验，用（ｘ ± ｓ）表示。结果 在ＣＴ测量参数参考下所有患者均手术成功，４８例（６４个椎体）模拟线满足单侧入路条件者穿刺成功率为１００％。３例在ＣＴ图像测量中不能满足单侧入路，改用双侧进路ＰＶＰ的方法。所有患者术后疼痛缓解率为１００％，随访期间未发生严重并发症。结论 对于不同患者、不同椎体ＰＶＰ手术穿刺角度及穿刺点选择是不同的，术前影像学资料测量穿刺参数可以确定单侧入路的可行性，能提高单侧椎弓根穿刺的安全性和成功率。

参考文献/References:

[1] Wold Health Organization (WHO). Cancer Pain Relief and Palli-ative Care: Report of a WHO Expert Committee [M]. Geneva:World Health Organization, 1990, 1275.
[2] 倪才方, 杨惠林, 唐天驷. 经皮椎体成形术的初步临床应用[J]. 介入放射学杂志, 2002, 4: 275 - 277.
[3] 孙 钢, 张殿星. 经皮椎体成形术规范化条例[J]. 介入放射学杂志, 2004, 1: 90 - 91.
[4] 张 继, 吴春根, 程永德, 等. 单侧椎弓根入路椎体成形术治疗骨质疏松性严重椎体压缩骨折[J]. 介入放射学杂志, 2008, 2:114 - 117.
[5] Kim AK, Jensen ME, Dion JE, et al. Unilateral transpedicular percutaneous vertebroplasty: initial experience[J]. Radiology, 2002, 222: 737 - 741.
[6] 刘爱华, 吴中学, 杨新健, 等. 单侧入路的椎体成形术治疗老年椎体压缩骨折[J]. 中国现代医学杂志, 2006, 16: 2623 - 2625, 2628.
[7] 滕皋军, 何仕成, 郭金和, 等. 经皮椎体成形术治疗椎体良恶性病变的临床技术应用探讨[J]. 中华放射学杂志, 2002, 36: 295 - 299.
[8] 倪才方, 吴春根, 杨惠林. 脊柱介入诊疗学[M]. 北京: 人民军医出版社, 2009: 149 - 152.
[9] 李 龙, 李 兵, 苟凌云, 等. 经皮椎体成形术治疗胸腰椎骨质疏松性压缩性骨折[J]. 中华微创外科杂志, 2007, 7: 621 - 662.
[10] Zindrick MR, Wiltse LL, Doornik A, et al. Analysis of the morphometric characteristics of the thoracic and lumbar pedicles[J]. Spine, 1987, 12: 160 - 166.
[11] Biafora SJ, Mardjetko SM, Butler JP, et al. Arterial injury fowllowing percutaneous vertebral augmentation: a case report[J]. Spine, 2006, 31: 84 - 87.
[12] Weber CH, Krotz M, Hoffmann RT, et al. CT guided verte-broplasty and kphop-asty: comparing technical success rate and complications in 101 cases[J]. Rofo, 2006, 178: 610 - 617.
[13] Powell MF, DiNobile D, Reddy AS. C-arm fluoroscopic cone beam CT for guidance of minimally invasive spine interventions﹖[J]. Pain Physician, 2010, 13: 51 - 59.
[14] Al-Ali F, Barrow T, Luke K . Vertebroplasty: what is important and what is not[J]. AJNR, 2009, 30: 1835 - 1839.
[15] Kim DJ, Kim TW, Park KH, et al. The proper volume and distribution of cement augmentation on percutaneous vertebro-plasty[J]. J Korean Neurosurg Soc, 2010, 48: 125 - 128.

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备注/Memo

备注/Memo:
收稿日期：２０１１０１１２
更新日期/Last Update: 2011-07-30