Effectiveness of percutaneous endoscopic technique in treatment of intraspinal cement leakage after percutaneous vertebroplasty

Objective: To evaluate the feasibility and safety of percutaneous endoscopic technique in the treatment of intraspinal cement leakage after percutaneous vertebroplasty (PVP). 方法: 2014 年 5 月—2016 年 3 月，应用经皮脊柱内镜下椎管内骨水泥取出减压术治疗 5 例 PVP 术后骨水泥椎管内渗漏致脊髓神经损伤患者。其中，男 3 例，女 2 例；年龄 65～83 岁，平均 74.4 岁；PVP 术后至该次入院时间为 10～30 d，平均 16.2 d。骨水泥渗漏节段：T 12、L 1 3 例，L 1、2 2 例；双侧渗漏 1 例，单侧渗漏 4 例。主要临床症状为下肢疼痛 2 例，疼痛视觉模拟评分（VAS）分别为 8 分及 7 分；下肢肌力减退 3 例，日本骨科协会（JOA）29 评分分别为 18、20、19 分。5 例神经功能根据美国脊髓损伤协会（ASIA）损伤分级为 E 级 2 例，D 级 3 例。. Results: The operation time was 55-119 minutes (mean, 85.6 minutes), and the blood loss was 30-80 mL (mean, 48 mL). CT scan and three-dimensional (3D) reconstruction at 1 day after operation showed that cement leakage was removed in all patients. Five cases were followed up 6-21 months (mean, 12 months). In 2 patients with lower limb pain, and VAS score was significantly decreased to 2 at last follow-up. In 3 patients with lower extremities weakness, the muscle strength was improved progressively, and the JOA29 scores at last follow-up were 21, 23, and 22. Conclusion: Percutaneous endoscopic technique for intraspinal cement leakage after PVP is safe, effective, and feasible.