척추체 압박 골절 환자에 대한 경피적 척추성형술의 수술적 결과

Abstract

Objective: The use of percutaneous vertebroplasty to treat osteoporotic vertebral fractures is increasing. This study is designed to identify the clinical efficacy and complication of percutaneous vertebroplasty in cases of painful and medically intractable vertebral compression fracture. Methods: One hundred and thirty two patients (41 men 91 women) underwent 164 percutaneous vertebroplasty under fluoroscopy. For the accurate diagnosis, all patients were performed simple X-ray, bone scan, and MRI. To assess leakage of the mixture into the epidural tissue, we then immediately obtained a post-procedural CT scan and simple X-ray assessing the clinical efficacy of the procedure on basis of time required for pain relief and ambulation without significant pain Results: Pain was relieveded within 1-3 days (mean POD 0.62 day) and early ambulation without significant pain was possible within 1-5 days (mean POD 1.23 day). Post-procedural CT scan and simple X-ray revealed leakage of the Polymethylmethacrylate(PMMA) - Barium mixture into paravertebral tissue (n=47), the paravertebral venous plexus (n=36), epidural space (n=4) and pulmonary embolism (n=1) patient of all surgical procedure. Conclusion: Percutaneous vertebroplasty is an effective interventional procedure. It relieves pain and provides early mobilization. But procedure related complication has shown to be not uncommon. Adequate preparation of PMMA, optimal needle tip point through venography and confirmation with biplane fluoroscopy are mandatory to minimize this type of complication.