Dissertation > Excellent graduate degree dissertation topics show

The Spinal Canal and Paravertebral Air Bubble Complication of Intraoperative Percutaneous Vertebroplasty and Percutaneous Kyphoplasty(with19Cases of summary)

Author: XuXianMing
Tutor: DengZhongLiang
School: Chongqing Medical University
Course: Surgery
Keywords: Spine fractures vertebroplasty Intraspinal air bubble complications
CLC: R687.3
Type: Master's thesis
Year: 2012
Downloads: 15
Quote: 0
Read: Download Dissertation


Objective:Percutaneous vertebroplasty(PVP) and percutaneous kyphoplasty (PKP) is a minimally invasive method of treating of vertebral compression fractures. A retrospective summary of the percutaneous vertebroplasty and kyphoplasty (PVP/PKP) with osteoporotic fractures which occurred spinal and paraspinal air bubble complications, analyze the reason and provide prevention reference for this complications.Methods:March2011to February2012, A total of432OPF patients (648vertebrae) had vertebroplasty(PVP/PKP). Include72males and360female. Age55-92years, mean age71.8years old. Surgery vertebral body from T3to S1, include87PVP cases of259vertebral bodies and345PKP cases of389vertebral bodies. The PVP were positioning disease vertebra with C-arm, sterilization and anesthesia, Under the fluoroscopic puncture,T3to T10with Pedicle rib head gap Puncture way, and T11to L5 with pedicle way. With (11-14) G of vertebroplasty needle Puncture to1cm about away from the anterior vertebral. Use Special putter Bolus injection of bone cement(polymethyl methacrylic,PMMA),1.5ml of each tube,Slow bolus the bone cement, Suture a needle after the PMMA good distribution, end of surgery. After the PKP puncture, Use a balloon catheter system of Vertebral expansion (KMC system) to expansion, pressure (100-300)Psi, Slow bolus the bone cement, Perspective distribution, end of surgery after suture a needle. Observed the Intraoperative and postoperative of patients with lower extremity symptoms, vital signs, VAS score changes. Take X-ray and CT inspection postoperative timely. follow-up2to25months(average12.8months). Summary tair bubble patients(Air bubble, AB) of the vertebral body, spinal canal and paravertebral with vertebral segment distribution, analyze the incidence of AB and which distribution location, and the relationship with vertebral posterior wall rupture rate,the relative position of the needle tract in the pedicle, leakage of bone cement, the injection quantity of bone cement, and the pressure PKP surgery.Results:The first postoperative day had372cases VAS score <3, the rate of Instantly ease86.1%(372/432), Decreased VAS score range of0to7.6. Other60cases were almost relieved in the5th postoperative day. Delay response rate was13.9%(60/432), All the patients VAS score <3 points in the5th postoperative day. The postoperative CT scans found the vertebral body and around of gas, a total of19cases (except1cases of preoperative CT showed the clearance of the psoas muscle-like gas), The AB incidence:4.62%(20/432),19cases of AB patients vertebral distribution as this:2cases of T5,1case of T8,3cases of T10,5cases of T12,4cases of L1,4cases of L2. Air bubble diameter from lmm to6.5mm, the AB of intraspinal (IAB) had12patients, six cases found gas in bone cement, and one cases Within the disc space had bubble. Two cases of12IAB have symptoms, incidence rate0.46%(2/432), One cases of lower limb pain, the other with lower limb paralysis, lower limbs muscle strength as Class I, both of them symptoms disappeared in the postoperative6-24hours. AB patients’ puncture channel in the relative position within the pedicle:4cases of pedicle central lateral side(21.1%),5cases of pedicle central (26.3%),10cases of pedicle Central medial (52.6%).13cases occurred in19cases of AB patients intraoperative fluoroscopy leakage of bone cement(include six cases of disc leakage, four cases of paravertebral leakage, three cases of Paravertebral venous leakage), Postoperative CT scan found a total of27cases of patients with bone cement leakage, including three cases of intraspinal occupying patients, three cases of PMMA leakage and AB patients, However, the leakage of bone cement were no associated symptoms. AB patients’ vertebral injection PMMA volume (2-6.0)ml, an average of4.6ml. The AB patients had6cases of PVP and13cases of PKP, and the PKP pressure (150-300) psi.Conclusion:Osteoporotic vertebral fractures take PVP/PKP can cause vertebrae and spinal canaland air bubble(AB) complications. AB can led to spinal cord and nerve root compression clinical manifestations; Its mechanism is not clear, May be related to the type of vertebral fractures and surgical operations.

Related Dissertations

  1. Clinical Analysis of Gynecologic Surgical Treatment in 193 Cases of Elderly Women,R713
  2. Thoracolumbar fractures compared two different grafting methods,R687.3
  3. Clinic Study of Treatment of Thoracolumbar Fractures (TLF)fixed with Short-segment Pedicle Instrumentation(SSPI) and Vertebroplasty with Injectable Calcium Sulfate (ICS),R687.3
  4. The Anti-tumor Effect of Polymethylmethacrylate Bone Cement in Different Viscous States:An Experimental Study in Rabbit Model,R687.3
  5. Analysis of the Long Term Complications of Patients Suffered from Subtotal Gastrectomy Due to Benign Gastroduodenal Diseases,R656.6
  6. The Clinical Follow-up of Sandwich Level Fracture after Vertebral Cement Augmentation,R687.3
  7. The Anti-tumor Effect of PMMA Bone Cement on Vertebral Tumor after Percutaneous Puncture Injection: Experimental and Preliminary Clinical Study,R687.3
  8. Hirschsprung compare different surgical curative effect,R726.5
  9. Study on the Mechanism of Metabolic Mem Ory of Hyperglycemia on Injury of Endothe Lial Cells,R587.1
  10. Clinical Study on Radiofrequency Ablation for Recurrent Hepatocellular Carcinoma in 24 Patients,R735.7
  11. Risk Prediction and Factors Research of Operative Complications in Elderly Patients with Soft Tissue Sarcoma,R735
  12. The Gestational Age and Delivery Type for Maternal and Perinatal Prognosis with Severe Preeclampsia,R714.24
  13. Decreasing Complication of Distally Based Sural Fasciocutaneous Flap: Sugical Techniques,R658.3
  14. Diagnosis and Treatment of Hepatic Artery Thrombosis after Liver Transplantation,R657.3
  15. Vertebroplasty Versus Nonoperative in Treatment of Vertebral Compression Fractures: A Systematic Review,R687.3
  16. Vertebral Compression Fractures with Intravertebral Vacuum Sign: Pathogenesis, Diagnosis and Treatment,R687.3
  17. The Clinical Research of Unilateral Puncture Percutaneous Vertebroplasty or Kyphoplasty Treatment of Thoracolumbar Osteoporotic VertebralComPression Fracture,R687.3
  18. Nonunion of Osteoporotic Vertebral Compression Fractures: Diagnosis and Treatment,R687.3
  19. PVP and PKP Treatment of Osteoporotic Thoracolumbar Vertebral Compression Fracture Analysis of the Efficacy,R687.3
  20. The Clinical Research of the Therapeutic Effect of Percutaneous Vertebroplasty (Percutaneous Kyphoplasty) in Treating Osteoporotic Vertebral Burst Fracture,R687.3
  21. Clinical Observation of Percutaneous Vertebroplasty in the Treatment of Thorocolumbar Osteoporotic Vertebral Compression Fractures,R687.3

CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Bone surgery
© 2012 www.DissertationTopic.Net  Mobile