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BACKGROUND:Pathological change and compression of multiple vertebra often occur following senile osteoporosis,myeloma and metastatic tumor.However,there are few studies concerning treatment of multiple vertebral lesion shaping.OBJECTIVE:To explore therapeutic efficacy,announcements of multiple pathological thorax-lumbar vertebrae treated with once only percutaneous vertebroplasty (PVP).DESIGN,TIME AND SETTING:The observational experiment.Patients were selected from the Department of Spinal Surgery,Department of Rehabilitation,and Department of Tumor,Taihe Hospital from November 2004 to October 2008.PARTICIPANTS:A total of 31 patients from the Department of Spinal Surgery,Department of Rehabilitation,and Department of Tumor,Taihe Hospital with senile osteoporosis combined with compression fracture,general lymphadenomatosis of bones and osteolytic metastatic tumor,14 males,17 females,with an age of 56-82 years old.METHODS:Thirty-one cases of multiple pathological thorax-lumbar vertebrae were treated with PVP.Following local anesthesia,affected vertebral body underwent vertebrae root puncturation.Under strict monitoring,bone cement was injected into the vertebral body in order.Following surgery,vertebral body condition and patients' reaction were observed.Therapeutic efficacy was evaluated 1 week following surgery.MAIN OUTCOME MEASURES:The following parameters were measured:centrum puncture success ratio,disposable centrum forming number,bone cement injection quantity,centrum bone cement distribution situation,leakage of bone cement to soft tissue and vein surrounding the vertebra,ache alleviation,and complications.RESULTS:A total of 75 vertebroplasy was used 33 times,2 vertebral bodies at least once only,and 5 vertebral bodies at most once only,with an average of 2.27 vertebral bodies once only.4-12 mL of bone cement was injected in each vertebral body,averagely 7.5 mL.Uniformity injection was done in 49 cases,and partial injection in 26 cases.Without serious complications,all the patients relieved in local pain parts following surgery.Significant remission or disappearance was determined in 20 cases,and partial remission in 11 cases.CONCLUSION:PVP is a safe and effective method in treatment of multiple pathological thorax-lumbar vertebrae.The key of operation is reasonable injection and thorough monitoring.
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Objective To explore the embolization technique,embolus choice and preventing complications of transcatheter internal iliac artery embolization in treating pelvis massive hemorrhage.Methods Bilateral selective internal iliac artery embolization utilizing gelfoam was done in 11 patients of pelvis massive hemorrhage (including 3 cases of bladder carcinoma,5 cases of cervix carcinoma,one case of choriocarcinoma and 2 cases of puerperal hemorrhage.Results Prompt hemostasis was obtained immediately after first embolization in all 11 patients,one of them showed recurrent bleeding after 24 hours and underwent treatment again.Patients were followed up for 10~90 days,no hemorrhage or any kind of complication noted in all patients.Conclusion Transcatheter internal iliac artery embolization is a simple,less invasive,safe and effective therapy for pelvis massive hemorrhage,should be taken as the first choice.
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Objective To study the methods,therapeutic effect and complications of transcatheter uterine artery embolization(TUAE)for hysteromyoma.Methods There were 82 patients with hysteromyoma confirmed by clinical,color Doppler ultrasound and CT in this study.Among them,5 hysteromyoma located under mucous membrane,72 in the myometrium,5 under serous membrane.15 cases were single hysteromyoma,67 were multiple hysteromyoma.Bilateral uterine arteries were embolized with lipiodol-pingyangmycin emulsion(LPE)and Gelfoam particles using Seldinger technique.All patients were followed up for 3 to 6 months.Results The successful rate of catheterization almost reached 100%.B-mode ultrasound examination 3 months after the procedure showed averagely 51% of decrease in volume of the masses and decrease of blood flow of tumors in all cases,the volume of tumors decreased 43% and 19 hysteromyoma disappeared for 6 months later.Menses returned to regular cycle.In the patients with anemia,the hemoglobin concentration recovered to normal level.The rate of complication was 6%(5/82),and recovered to normal after special treatment.Conclusion TUAE is an effective and less invasive way to treat hysteromyoma,the complications of TUAE are preventable and curable.
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Objective To study the clinical value of DSA diagnosis and interventional therapy for non-neoplastic lower digestive tract hemorrhage. Methods Non-neoplastic lower digestive tract hemorrhage were diagnosed in 21 patients. Eight cases underwent embolization with gelfoam and 13 cases with infusion of pitressin. Results Intestinal angiodysplasia was found in 14 cases, colonic diverticulum in 2 and hemorrhage of unknown cause in 5. Hemorrhage in all patients was stopped after the interventional therapy with no serious complications. During the follow-up of 25～74 months, intestinal angiodysplasia bleeding recurred in 4 patients. Conclusions DSA is very helpful in the diagnosis of non-neoplastic lower digestive tract hemorrhage and interventional therapy is safe and effective for the stoppage of the bleeding.