Tseng Y-Y, Yang S-T, Tu P-H, Yang T-C, Lo Y-L
Department of Neurosurgery, Chang Gung Memorial Hospital & Chang Gung University, Taoyuan, Taiwan, ROC.
Minim Invasive Neurosurg. 2008 Oct;51(5):280-4. doi: 10.1055/s-0028-1082328. Epub 2008 Oct 14.
Spinal metastatic tumor is a common problem and represents a challenging problem in oncology practice. Patients with osteolytic metastases often suffer from intractable local and/or radicular pain. Percutaneous vertebroplasty is a minimally invasive, radiologically guided procedure whereby bone cement is injected into structurally weakened vertebrae to provide immediate biomechanical stability. Vertebroplasty is also used to relieve pain by stabilizing metastatically compromised vertebrae that are at risk of pathological burst fracture. In this retrospective study, a total of 57 patients (78 vertebrae) with spinal metastatic tumor were treated with PMMA vertebroplasty. The mean value of the visual analogue scale (VAS) was 8.1 +/- 0.67 preoperatively, and significantly decreased to 3.8 +/- 1.9 (1-8, p < 0.015) one day after vertebroplasty. The mean VAS value 6 months after vertebroplsty was 2.8 +/- 2.0 (p < 0.001). Mean injected bone cement amount in our study is 5.16 +/- 1.6 mL. The complication rate is about 21.8%, bone cement extravasation without neurological deficit is the most common complication. No new or adjacent vertebral fracture has occurred in more than 2 years follow-up. Percutaneous vertebroplasty is a minimally invasive procedure that offers a remarkable advantage of effective and immediate pain relief with few complications.
脊柱转移性肿瘤是一个常见问题，也是肿瘤学实践中一个具有挑战性的难题。溶骨性转移患者常遭受顽固性局部和/或神经根性疼痛。经皮椎体成形术是一种在放射学引导下的微创手术，通过将骨水泥注入结构薄弱的椎体以提供即时的生物力学稳定性。椎体成形术还可通过稳定有病理爆裂骨折风险的转移性受损椎体来缓解疼痛。在这项回顾性研究中，共有57例（78个椎体）脊柱转移性肿瘤患者接受了聚甲基丙烯酸甲酯椎体成形术治疗。术前视觉模拟评分（VAS）的平均值为8.1±0.67，椎体成形术后1天显著降至3.8±1.9（1 - 8，p < 0.015）。椎体成形术后6个月的平均VAS值为2.8±2.0（p < 0.001）。我们研究中平均注入的骨水泥量为5.16±1.6 mL。并发症发生率约为21.8%，无神经功能缺损的骨水泥渗漏是最常见的并发症。在超过2年的随访中未发生新的或相邻椎体骨折。经皮椎体成形术是一种微创手术，具有有效且即时缓解疼痛且并发症少的显著优势。
