骨填充网袋辅助经皮椎体成形术治疗伴椎体后壁破损的脊柱转移瘤

发布时间：2018-06-23 12:43

本文选题：椎体转移瘤 + 经皮椎体成形术　；参考：《介入放射学杂志》2017年09期

【摘要】：目的探讨经皮椎体成形术(PVP)在骨填充网袋辅助下治疗因转移瘤致椎体后壁破损性骨折的疗效及安全性。方法 31例患者因脊柱转移瘤致椎体后壁破坏而接受骨填充网袋辅助PVP治疗,共43节病变椎体。所有患者原发肿瘤均诊断明确。PVP术前1 d,术后1 d、3 d、1个月、3个月和末次随访采用视觉模拟评分(VAS)评估疼痛程度,Oswestry功能障碍指数(ODI)评估患者运动功能状态。术后记录骨水泥渗漏情况。结果 43节椎体PVP手术成功率100%。术前VAS评分8.2±0.4,术后1 d降至2.5±0.7;术前VAS评分均明显高于术后1 d、3 d、1个月、3个月和末次随访,差异有统计学意义(P均0.05)。术后ODI均较前明显降低(P均0.05),患者运动功能状态得到改善。术后影像学(DSA、CT)证实无严重骨水泥渗漏事件发生。结论 PVP在骨填充网袋辅助下治疗因转移瘤致椎体后壁破损性骨折是安全可靠的,并能获得良好的止痛效果及改善患者运动功能状态。
[Abstract]:Objective to evaluate the efficacy and safety of percutaneous vertebroplasty (PVP) in the treatment of fracture of the posterior wall of vertebral body caused by metastatic tumor. Methods 31 cases of vertebral posterior wall destruction caused by spinal metastases were treated with bone pouch assisted PVP. All the primary tumors were diagnosed clearly at 1 day before operation, 1 day, 1 month, 3 months and the last follow-up. The degree of pain was evaluated by visual analogue scale (VAS) and Oswestry dysfunction index (ODI) was used to evaluate the motor function of the patients. Bone cement leakage was recorded after operation. Results the success rate of PVP in 43 vertebrae was 100%. The preoperative VAS score was 8.2 卤0.4, and decreased to 2.5 卤0.7 on the 1st day after operation, and the preoperative VAS score was significantly higher than that at 1 day, 1 month, 3 months and the last follow-up (P 0.05). The postoperative ODI was significantly lower than that of the former (P 0.05), and the motor function of the patients was improved. Postoperative imaging (DSA-CT) confirmed no severe bone cement leakage. Conclusion PVP is safe and reliable in the treatment of fracture of the posterior wall of vertebral body caused by metastatic tumor, and can obtain good analgesic effect and improve the motor function of the patients.
【作者单位】：四川省肿瘤医院介入科;贵州医科大学附属医院介入科;
【分类号】：R738

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