Jensen Mary E, Kallmes David E
Department of Radiology and Neurosurgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Cancer J. 2002 Mar-Apr;8(2):194-206. doi: 10.1097/00130404-200203000-00013.
Percutaneous vertebroplasty is a minimally invasive, radiologically-guided interventional procedure originally developed in France for the treatment of painful vertebral hemangiomas. The technique consists of the percutaneous puncture of the affected vertebral body, followed by injection of an acrylic polymer to provide bone augmentation and prevent further collapse. The internal "casting" of the trabecular microfractures results in pain relief and vertebral consolidation. Vertebroplasty was quickly adopted for use in metastatic vertebral lesions and hematologic malignancies such as multiple myeloma and lymphoma. The major experience with malignant disease has remained primarily in the European realm; in the United States vertebroplasty is used mainly for the treatment of osteoporotic compression fractures. The reasons underlying this divergence in practice experiences remains unclear, although the explosion of vertebroplasty in the U.S. appears to be driven by an assertive, motivated and well-informed elderly population. In addition, malignant lesions are often challenging and practitioners may shy away from these clinically and technically more difficult patients. The purpose of this article is to introduce the principles of percutaneous vertebroplasty to the North American oncologic community with the hope that it mayfind a greater role in the treatmentof malignant disease affecting the spine.
经皮椎体成形术是一种微创的、在放射学引导下的介入手术，最初由法国研发用于治疗疼痛性椎体血管瘤。该技术包括经皮穿刺受影响的椎体，随后注入丙烯酸聚合物以增强骨质并防止进一步塌陷。对小梁微骨折进行内部“铸型”可缓解疼痛并实现椎体巩固。椎体成形术很快被应用于转移性椎体病变以及血液系统恶性肿瘤，如多发性骨髓瘤和淋巴瘤。恶性疾病的主要经验主要仍集中在欧洲；在美国，椎体成形术主要用于治疗骨质疏松性压缩骨折。尽管美国椎体成形术的迅速发展似乎是由自信、积极且消息灵通的老年人群推动的，但这种实践经验差异背后的原因仍不清楚。此外，恶性病变往往具有挑战性，从业者可能会回避这些临床和技术上更困难的患者。本文的目的是向北美洲肿瘤学界介绍经皮椎体成形术的原理，希望它在影响脊柱的恶性疾病治疗中能发挥更大作用。
