Percutaneous vertebroplasty: State of the art
Percutaneous vertebroplasty: State of the art
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DOI：
10.1148/radiographics.18.2.9536480
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发表时间：
1998-03-01
期刊：
影响因子：
5.5
通讯作者：
Deramond, H
中科院分区：
文献类型：
--
作者：
Cotten, A;Boutry, N;Deramond, H
椎体成形术是一种有效的新的放射学方法，包括经皮注射生物材料，通常是甲基丙烯酸甲酯，进入椎体的病变，这种技术在大多数情况下可以显著或完全缓解疼痛和骨强化，椎体成形术的主要适应症是溶骨性转移和骨髓瘤，疼痛或侵袭性血管瘤，以及尽管进行了正确的药物治疗但仍持续存在的伴有衰弱性疼痛的退行性椎体塌陷，必须在椎体成形术前几天进行X线摄影和计算机断层扫描，以评估椎体塌陷的程度，溶解过程的位置和程度、椎弓根的可见性和受累程度、皮质破坏或骨折的存在以及由肿瘤延伸或骨碎片后移引起的硬膜外或椎间孔狭窄的存在。椎体成形术中甲基丙烯酸甲酯的泄漏可能会导致邻近结构的压缩，需要紧急减压手术;因此，该手术应仅在外科中心进行。进行椎体成形术的决定应由多学科团队做出，因为椎体成形术，手术，放射治疗，药物治疗或其组合之间的选择取决于许多因素，放射科医生需要了解椎体成形术的各种适应症以及该手术的潜在未来发展和应用。
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.