应用骨填充网袋椎体成形术治疗胸腰椎溶骨性转移瘤

发布时间：2018-01-29 00:34

  本文关键词： 骨填充网袋 椎体成形术 胸腰椎转移瘤 骨水泥渗漏　出处：《中国脊柱脊髓杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的 :探讨应用骨填充网袋椎体成形术治疗胸腰椎溶骨性转移瘤的临床疗效。方法 :2012年10月~2016年10月应用经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗胸腰椎溶骨性转移瘤病例48例,共77个椎体。其中23例37个椎体行传统PVP(传统PVP组),25例40个椎体应用骨填充网袋(bone filling mesh container,BFMCs)行PVP(BFMCs组),两组患者年龄、性别比和椎体分布均无统计学差异。术中在C型臂透视下观察骨水泥渗漏情况,术后第3天采用VAS评分评估患者疼痛缓解情况、根据Oswestry功能障碍指数(Oswestry disability index,ODI)对活动能力改善进行评估,出院前复查X线、CT观察受累椎体高度复位程度。结果:所有患者均顺利完成手术,穿刺成功率为100%,术中未出现肺栓塞、截瘫或围手术期死亡。传统PVP组术中18个椎体(48.6%,18/37)出现骨水泥渗漏,但患者均无骨水泥渗漏的临床症状,BFMCs组术中无1例出现骨水泥渗漏。所有患者术后3d内疼痛缓解,传统PVP组VAS评分由术前7.8±1.3分(5~10分)降至2.4±1.4分(1~4分),BFMCs组VAS评分由术前7.9±1.1分(6~10分)降至2.5±1.3分(1~4分);ODI传统PVP组由术前(73.4±4.6)%降至(23.6±4.3)%,BFMCs组由术前(74.6±4.9)%降至(23.9±4.5)%。两组术后VAS评分和ODI与术前比较均有显著性差异(P0.05),两组间术前、术后比较均无显著性差异(P0.05)。术后病椎前缘和中部高度抬升百分比传统PVP组分别为(3.2±2.6)%、(5.4±4.1)%,BFMCs组分别为(11.8±11.6)%、(22.1±14.7)%,两组比较差异有统计学意义(P0.05)。结论:对于胸腰椎溶骨性转移瘤患者应用骨填充网袋行PVP可明显降低骨水泥椎体外渗漏率,更好地恢复椎体高度,在疼痛缓解与活动能力改善方面与传统PVP相似。
[Abstract]:Objective: To evaluate the clinical application of bone filling bag vertebroplasty for thoracolumbar vertebral osteolytic metastases. Methods: October 2012 ~2016 year in October the application of percutaneous vertebroplasty (percutaneous, vertebroplasty, PVP) solution for the treatment of thoracolumbar metastatic tumors and 48 patients with a total of 77 cases of osteoarthritis, 23 cases of vertebral body. 37 vertebrae underwent conventional PVP (PVP group), 25 patients with 40 vertebral bone filling bag (bone filling mesh container, BFMCs) PVP (BFMCs group), two groups of patients with age, sex ratio and body distribution were not statistically significant. In the operation of C arm fluoroscopy observation of bone cement leakage, third days after surgery using VAS score to evaluate the pain relief, according to the Oswestry disability index (Oswestry disability index, ODI) for activity improvement was assessed before X-ray discharge, CT observation of vertebral height reduction involvement degree. Results: all patients were successfully 鍒╁畬鎴愭墜鏈，

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