Masala S, Fiori R, Massari F, Simonetti G
Department of Diagnostic Imaging and Interventional Radiology, University of Rome Tor Vergata, Italy.
J Exp Clin Cancer Res. 2003 Dec;22(4 Suppl):75-9.
The Purpose of our study was to assess the effectiveness and safety of Percutaneous Vertebroplasty and Kyphoplasty, in the treatment of pain deriving from neoplastic vertebral compression fractures (VCF). We treated with these new techniques oncologic patients with unremitting pain over spine, refractory to the conventional medical therapy (analgesics, bed-rest, bracing and bisphosphonates), elicited by pressure over spinous process and in absence of neurological signs. Both methods demonstrated a swift pain relief associated with an evident augmentation in vertebral body resistance. Nevertheless only Kyphoplasty revealed itself able to restorate the original somatic morphology and to diminish the spinal kyphosis. Polymethylmethacrylate's leakages (PMMA) not observed in the Kyphoplasty, instead have been found in the Vertebroplasty localized in the intersomatic or perispinal areas. Neither confirmation of epidural or foraminal extravasations, nor complications which pulmonary embolism for the involvement of venous plexus or connected to phenomenon of infection having to do with the procedures. Kyphoplasty and Vertebroplasty are effective alternatives, simple and safe in the treatment of vertebral collapses consequent to aggressive haemangiomas, myelomas and metastases. This entails a complete relief of symptoms and restoration of mobility in 90% of patients within 24 hours from the procedure.
我们研究的目的是评估经皮椎体成形术和后凸成形术治疗因肿瘤性椎体压缩骨折（VCF）引起的疼痛的有效性和安全性。我们用这些新技术治疗了患有脊柱持续性疼痛的肿瘤患者，这些疼痛对传统药物治疗（镇痛药、卧床休息、支具和双膦酸盐）无效，由棘突受压引起且无神经体征。两种方法均显示出迅速的疼痛缓解，并伴有椎体抵抗力明显增强。然而，只有后凸成形术能够恢复原来的身体形态并减少脊柱后凸。在后凸成形术中未观察到聚甲基丙烯酸甲酯（PMMA）渗漏，而在椎体间或脊柱周围区域的椎体成形术中发现了渗漏。既没有硬膜外或椎间孔外渗的证实，也没有因静脉丛受累或与手术相关的感染现象导致肺栓塞的并发症。后凸成形术和椎体成形术是有效的替代方法，在治疗侵袭性血管瘤、骨髓瘤和转移瘤导致的椎体塌陷方面简单且安全。这使得90%的患者在手术后24小时内症状完全缓解并恢复活动能力。
