Anselmetti Giovanni Carlo, Corrao Giovanni, Monica Patrizia Della, Tartaglia Vincenzo, Manca Antonio, Eminefendic Haris, Russo Filippo, Tosetti Irene, Regge Daniele
Interventional Radiology Unit, Institute for Cancer Research and Treatment (IRCC), Strada Provinciale No.135 Km.3, 95 10060 Candiolo, Turin, Italy.
Cardiovasc Intervent Radiol. 2007 May-Jun;30(3):441-7. doi: 10.1007/s00270-006-0146-0.
The aim of this study was to assess if percutaneous vertebroplasty (PVP) could relieve back pain, reduce drug consumption, and improve the mobility of patients with metastases and vertebral compression fractures. From August 2002 to July 2004, 283 patients (216 females; mean age: 73.8 +/- 9.9 years) underwent PVP on 749 vertebrae. Pain was evaluated with the pain intensity numeric rating scale (PI-NRS) (0 = no pain; 10 = worst pain) before the procedure and at the end point in September 2004 (follow-up:1-24 months; median: 7 months). A reduction of at least two points of the PI-NRS score was considered clinically relevant. Two hundred four patients were available for evaluation at the end point. Overall results showed a reduction of the median pain score from 8 at baseline to 1 at the end point (p < 0.0001); a clinically relevant pain reduction was observed in 176/205 patients (86%); 89/147 patients (61%) gave up a brace support (p < 0.0001); and 117/190 patients (62%) gave up drug therapy. Results were similar in different subgroups stratified according to age, underlying pathology, number of fractured or treated vertebrae, and length of follow-up. This study adds evidence that PVP is effective in treating painful vertebral fractures. A significant reduction in drug assumption and significant mobility improvement can also be achieved.
本研究的目的是评估经皮椎体成形术(PVP)是否能够缓解背痛、减少药物用量并改善患有转移瘤和椎体压缩骨折患者的活动能力。2002年8月至2004年7月,283例患者(216例女性;平均年龄:73.8±9.9岁)接受了749节椎体的PVP手术。在手术前以及2004年9月的终点(随访:1 - 24个月;中位数:7个月),使用疼痛强度数字评定量表(PI - NRS)(0 = 无疼痛;10 = 最严重疼痛)评估疼痛情况。PI - NRS评分至少降低2分被认为具有临床意义。在终点时有204例患者可供评估。总体结果显示,疼痛评分中位数从基线时的8分降至终点时的1分(p < 0.0001);176/205例患者(86%)观察到具有临床意义的疼痛减轻;89/147例患者(61%)不再使用支具(p < 0.0001);117/190例患者(62%)停止药物治疗。根据年龄、基础病理、骨折或治疗椎体数量以及随访时间分层的不同亚组中,结果相似。本研究补充了证据表明PVP在治疗疼痛性椎体骨折方面是有效的。药物用量也显著减少,并且活动能力也得到显著改善。