The application value of vertebral body venography in performance of percutaneous vertebroplasty / 中华骨科杂志

ABSTRACT

Objective To evaluate the clinical value of vertebral body venography in performance of percutaneous vertebroplasty(PVP). Methods 92 patients with 124 vertebraes underwent PVP. Before injecting the bone cement, venography was performed with injection of nonionic contrast material into vertebral body. 124 vertebraes were classified into four groups according to the results of vebgrophy. Group A no draining veins displayed; group B draining veins appeared late; group C draining veins appeared ahead of time; group D draining veins appeared ahead of time, then intervention such as adjusting the puncture needle's position or gelatin sponge embolization of vein was performed to delay the appearance of veins. Results 94 of 124 vertebraes displayed draining veins. According to the results of vebgrophy, there're 30 vertebraes in group A, 25 in group B, 30 in group C, 39 in group D. Thirty-seven vertebraes demonstrated cement extravasation, cement entering vein was observed in sixteen vertebraes and two patients among them had pulmonary embolism. Venograms showed all correlative venous extravasation. Bone cement extravasation rate of each groups was 20.0%, 24.0%, 56.7% and 20.5% respectively. Moreover, extravasation rate of group C was higher than any other group. Pain reduction was observed in 88 of 92 patients after 30 days of the operation, the rate of pain relief was 95.7%. Conclusion Vertebral body venography could describe the velocity of venous blood flow within vertebral body and predict the direction of bone cement leaking to veins effectively, which could provid valuable information in takeing some measures to prevent bone cement leaking into veins. Vertebral body venography has very impotant clinical value in improving the safety and preventing complication of PVP.