Résumé
Objective To investigate the causes and prevention on complications of percutaneous vertebroplasty(PVP). Methods Forty three cases with 64 vertebrae were performed PVP from May 2001 to October 2003. The incidence of complication was 13 cases (30.2%). Leakage of polymethylmethacry (PMMA) without symptoms occurred in 4 cases. Leakage with pain occurred in 3 cases. No leakage but with pain occurred in 4 cases after the procedure. Fracture of adjacent vertebrae occurred in 2 cases. All cases were followed up from 3 to 29 months (in average of 13.2 months). Results There wasn′t severe complications in 7 leakage cases. The pain in 7 cases was relieved and disappeared at 2-7 days after the procedure. The symptoms of pain in 2 cases of adjacent vertebrae fracture were relieved. Conclusion If sufficient preventive measures are applied before or during the procedure of PVP,the complications may be reduced effectively.
Résumé
Objective To discuss the application of Apofix interlaminar clamp for the treatment of atlantoaxial instability. Methods From April 2000 to July 2004, 30 patients with atlantoaxial instability were treated with posterior atlantoaxial fusion and Apofix fixation. There were 24 males and 6 females. The mean age of the patients was 41 years (range, 19 to 67 years). The patients included 5 with atlantoaxial dislocation, 25 with odontoid fracture (including fresh fracture for 21, old fracture and nonunion for 4; Anderson Ⅱ for 23 and Anderson Ⅲ for 2). After reducted by skull traction, atlanto-occipital space, arcus posterior atlantis and axial laminar were exposed during operation, upper and lower hooks were inserted. The iliac bone graft was inserted into the space of C1 and C2, the connecting rod of the clamp was compressed and fixed. Results The follow-up of all cases ranged from 8 months to 3 years and 10 months (with the mean of 27 months). There were 28 cases with complete reduction of fracture and dislocation, 2 cases in incomplete reduction. The operation time was 70 to 150 minutes, and the average blood loss was 65 ml. Patients could sit up 3 days (2 to 6 days) after surgery with soft collar. The mean off-bed time was 7 days (2 to 10 days) after operation in the patients without or less spinal cord injury. All cases obtained solid bony fusion 3 months postoperatively. No severe complications such as injuries of vertebral artery, nerve root and spinal cord or aggravation of spinal cord injury occurred. Conclusion Apofix interlaminar clamp has advantages of convenience in operation, provided reliable and safe stability for atlatoaxial segment. The results suggested that this technique is an efficient, reliable segmental posterior fixation.