Masala Salvatore, Konda Daniel, Massari Francesco, Simonetti Giovanni
Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, Italy.
Spine (Phila Pa 1976). 2006 Aug 15;31(18):E667-9. doi: 10.1097/01.brs.0000231962.04739.ac.
We postulate that osteoplasty of osteolytic metastases of the pelvic region performed by computed tomography (CT)-guided insertion of Kirschner wires into the lesions is effective and more feasible.
To determine whether osteoplasty of osteolytic metastases of the pelvic region can be performed by a more feasible lesion access, increasing patient compliance and reducing patient radiation exposure.
Treatment of osteolytic bone metastases is palliative and relies mainly on the elimination of pain. When pain is medically intractable, this can be effectively treated by osteoplasty.
A 61-year-old man with medically intractable pain from osteolytic lesions of the sacral ala and left iliac alum from pulmonary adenocarcinoma underwent osteoplasty. The lesions were accessed using Kirschner wires under CT guidance. Subsequently, under high-resolution fluoroscopic guidance, 13-G biopsy needles were advanced coaxially over the Kirschner wires and polymethyl methacrylate (PMMA) was injected into the lesions.
No peri-procedural complications were observed. The patient experienced an immediate and substantial pain relief that was persistent during a 4-month follow-up.
This technique is safe and effective and requires fewer CT scans, thus reducing the patient's radiation exposure. The shorter procedure correlates to a better patient tolerance.
我们推测，通过计算机断层扫描（CT）引导将克氏针插入盆腔溶骨性转移瘤进行骨成形术是有效且更可行的。
确定是否可以通过更可行的病变入路对盆腔溶骨性转移瘤进行骨成形术，提高患者的依从性并减少患者的辐射暴露。
溶骨性骨转移瘤的治疗是姑息性的，主要依靠消除疼痛。当疼痛在医学上难以治疗时，可通过骨成形术有效治疗。
一名61岁男性因肺腺癌导致骶骨翼和左髂骨溶骨性病变出现医学上难以治疗的疼痛，接受了骨成形术。在CT引导下使用克氏针进入病变部位。随后，在高分辨率荧光透视引导下，将13G活检针沿克氏针同轴推进，并将聚甲基丙烯酸甲酯（PMMA）注入病变部位。
未观察到围手术期并发症。患者疼痛立即得到显著缓解，并在4个月的随访期间持续缓解。
该技术安全有效，所需CT扫描较少，从而减少了患者的辐射暴露。手术时间较短与患者更好的耐受性相关。
