The Role of Imaging Studies of Percutaneous Vertebroplasty in 63 Patients with Osteoporotic Compression Fracture: Preliminary Report

影像檢查在經皮穿刺脊椎整形術治療63位壓迫性骨折病人的角色：初步結果報告

林偉哲(Wei-Che Lin) ； 陳松雄(Sung Hsiung Chen) ； 鄭添財(Tien-Tsai Cheng) ； 陳世豪(Shih-Hao Chen) ； 賴漢明(Han-Ming Lai) ； 呂鎮中(Chun-Chung Lui)

《中華放射線醫學雜誌》 29卷4期 (2004/08) Pp. 177-184

摘要

探討影像檢查在經皮穿刺脊椎整形術治療因骨質疏鬆性脊椎壓迫性骨折併發的背痛所扮演的角色。
共63位病人（12位男性51位女性；66個椎體）因為脊椎壓迫性骨折所引起的疼痛無法以藥物獲得緩解而接受經皮穿刺脊椎整形術的治療。手術前，病人會接受素片、電腦斷層或磁振造影的檢查，以確定病灶所在的位置。病人以靜脈注射鎮定劑後利用雙方位的透視X光機施行手術。在注射人工骨泥前（PMMA），都先施行椎體內靜脈攝影。術後病人立即接受電腦斷層檢查以評估人工骨泥注射的情形。3個月後再以問卷的方式評估病人疼痛改善的程度。
經過16個月的追蹤，86%的病人疼痛獲得的改善，86%的病人覺得滿意。臨床上，有一位病人術後發生疑似肺栓塞的症狀。總體的併發症則為1.6%。結果顯示，術前磁振造影檢查對於術前病人的評估及計畫具有非常重要的角色。
在熟手與好的透視機導引下，經皮穿刺脊椎整形術對於壓迫性骨折所引起的疼痛是一種微侵入性且有效的治療。而各項影像檢查間是相輔相成的，且都有其重要性。

關鍵字

脊椎整形術 ； 壓迫性骨折 ； 磁振造影 ； 骨質疏鬆

並列摘要

To evaluate the role of imaging studies for percutaneous vertebroplasty to treat back pain associated with osteoporotic compression fractures for the vertebral bodies.
Sixty-three patients (51 women, 12 men; mean age, 70.6 y/o) suffering from back pain refractory to medical treatment received percutaneous injections of polymethylmethacrylate (PMMA) into 66 vertebrae (32 thoracic and 34 lumbar) under biplane fluoroscopic guidance. Plain radiograph, computed tomography, and/or magnetic resonance imaging were performed for pre-operation survey. During the procedure, intraosseous venography was performed before PMMA injection. After the procedure, plain radiograph and CT of each treated vertebral level were obtained immediately to evaluate the migration of PMMA. At follow-up 3 months after vertebroplasty, patients were asked to complete a questionnaire.
The procedures were technically successful in all patients. After treatment, fifty-four (86%) patients reported improvement in back pain from compression fractures. Fifty-four (86%) patients reported satisfaction with percutaneous vertebroplasty. The single serious adverse event involved clinically was suspected pulmonary embolism syndrome. The complication rate was 1.6 percent. In multiple compression fractures, pre-operative MRI evaluation is very helpful for determining appropriate treatment.
Percutaneous vertebroplasty is a minimally invasive procedure which can provide satisfactory symptomatic relief for patients with refractory back pain associated with osteoporotic compression fracture. All kinds of imaging studies play their own roles in the procedure.

並列關鍵字

Spine ； Vertebroplasty ； Spine ； Fractures ； MR imaging ； Osteoporosis