Polymethyl methacrylate cement injection in vertebroplasty

doi:10.3969/j.issn.2095-4344.2013.21.004

Abstract

Abstract:

BACKGROUND: Percutaneous vertebroplasty can embolize vertebral hemangioma, strengthen vertebral strength, and has analgesic effect.
OBJECTIVE: To investigate the clinical effects of percutaneous vertebroplasty in the treatment of symptomatic cervical, thoracic, and lumbar hemangiomas.
METHODS: A retrospective analysis was performed in 25 patients who had single cervical (n=3), thoracic (n=12) or lumbar (n=10) vertebral hemangioma and accepted percutaneous vertebroplasty via polymethyl methacrylate cement injection under C-arm X-ray guidance. Ordinary radiographs were performed to observe the changes of the vertebral height and distribution and leakage of bone cement postoperatively. The local pain was measured by visual analogue scale and Oswesty functional scores preoperatively and postoperatively.
RESULTS AND CONCLUSION: No spinal cord and nerves injury occurred during the operation. The visual analogue scale and Oswesty scores had a significant decrease 3 days after operation and at the final follow-up (P < 0.05). During the follow-up periods, there was no significant vertebral height loss (P > 0.05), and no vertebral hemangioma recurrence happened. Percutaneous vertebroplasty is an effective therapeutic option for symptomatic vertebral hemangiomas, which has the characteristics of minimally invasive, low-risk, short recumbent period, and rapid pain relief. However, more attention should be paid in cortex deficiency cases to avoid bone cement leakage.

Key words: biomaterials, tissue-engineered bone materials, spinal vertebral hemangioma, percutaneous vertebroplasty, bone cement, polymethyl methacrylate, vertebral height, clinical efficacy, visual analogue scale

CLC Number:

R318

Hu Cheng-dong, Liu Xi, Zhou Yu-jun, Liu Fa-jing, Li Dong-feng, Huo Xi-wei, Li Hai-tao, Liu Ji-xiang. Polymethyl methacrylate cement injection in vertebroplasty[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.21.004.

Figures/Tables 4

References

[1] Fox MW,Onofrio BM.The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. J Neurosurg.1993;78(1):36-45．

[2] Acosta FL Jr,Sanai N,Chi JH,et al.Comprehensive management of symptomatic and aggressive vertebral hemangiomas.Neurosurg Clin N Am.2008;19(1):17-29.

[3] Templin CR,Stambough JB,Stambough JL.Acute spinal cord compression caused by vertebral hemangioma. Spine J. 2004;4(5):595-600.

[4] Ren H,Shen Y,Yang DL.Zhongguo Jizhu Jisui Zazhi. 2009; 19(5):392-394.任虎,申勇,杨大龙.经皮椎体成形术的研究进展[J].中国脊柱脊髓杂志,2009,19(5):392-394.

[5] Peng XZ,Chen M,Wu ZG,et al.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu.2011;15(8):1515-1518.彭小忠,陈明,武振国,等.经皮椎体成形102例中22例骨水泥渗漏原因[J].中国组织工程研究与临床康复,2011,15(8):1515-1518.

[6] Wang LJ,Hu ZM,Hao J. Zhongguo Jizhu Jisui Zazhi. 2011; 21(3):256-257.汪礼军,胡侦明,郝杰. 经皮椎体成形术治疗症状性椎体血管瘤[J].中国脊柱脊髓杂志,2011,21(3):256-257.

[7] Liu ZW,Yan JY,Liu FJ,et al. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2011;15(48):9096-9099.刘振武,颜继英,刘法敬,等. 骨密度测量与胸腰椎压缩骨折植入物治疗方式的选择[J].中国组织工程研究与临床康复,2011, 15(48):9096-9099.

[8] Jian FZ,Chen Z,Zhang HQ,et al.Zhongguo Jizhu Jisui Zazhi. 2006;16(10):751-754.菅凤增,陈赞,张鸿祺,等.症状性椎体血管瘤的外科治疗[J].中国脊柱脊髓杂志,2006,16(10):751-754.

[9] San Millán Ruíz D,Burkhardt K,Jean B,et al.Pathology findings with acrylic implant.Bone.1999;25(2Suppl):85-90.

[10] Liu FJ,Shen Y,Ding WY,et al.Zhongguo Xiufu Chongjian Waike Zazhi. 2011;25(1):74-78.刘法敬,申勇,丁文元,等.症状性颈椎血管瘤合并脊髓型颈椎病的手术治疗[J].中国修复重建外科杂志,2011,25(1):74-78.

[11] Van den Broeck S,Mailleux P,Joris JP.A minimally invasive vertebral hemangioma.JBR-BTR.2010;93(1):1-3.

[12] Gao LB,Li J,Zhang L,et al.Zhonghua Chuangshang Guke Zazhi. 2007;9(7):612-615.高梁斌,李健,张亮,等.CT或C型臂引导经皮椎体成形术[J].中华创伤骨科杂志,2007,9(7):612-615.

[13] Li ZL,Zhou SY,Shen HQ,et al.Zhongguo Zhongyi Gushangke Zazhi. 2012;20(6): 43-44.李中连,周森叶,沈海琦,等.关于经皮椎体成形术骨水泥注入量及相关技术的应用分析[J].中国中医骨伤科杂志,2012,20(6): 43-44.

[14] Gou LY,Li B,Zhang X,et al. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2007;11(35):6978-6982.苟凌云,李兵,张贤,等. 经皮椎体注入骨水泥剂量与老年骨质疏松压缩性骨折椎体高度的恢复:1年随访验证[J].中国组织工程研究与临床康复,2007,11(35):6978-6982.

[15] Shen Y,Ren H,Zhang YZ,et al.Zhongguo Xiufu Chongjian Waike Zazhi. 2010;24(1):27-31.申勇,任虎,张英泽,等.经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折骨水泥渗漏的相关因素分析[J].中国修复重建外科杂志, 2010,24(1):27-31.

[16] Teng HJ,Zhou Y,Fan LJ,et al.Zhongguo Linchuang Kangfu. 2004;8(32):7316-7317.滕海军,周跃,范丽静,等. 椎体成形术对实验犬心肺功能的影响[J].中国临床康复,2004,8(32):7316-7317.

[17] Yao XG,Shen Y,Zhang YZ,et al.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2009;13(51):10197-10199.姚晓光,申勇,张英泽,等. 经皮椎体成形术中骨水泥填充对患者凝血功能的影响[J].中国组织工程研究与临床康复, 2009, 13 (51): 10197-10199.