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多发性骨髓瘤的经皮椎体成形术:106 例连续患者的前瞻性长期随访。

Percutaneous vertebroplasty in multiple myeloma: prospective long-term follow-up in 106 consecutive patients.

机构信息

Interventional Radiology Unit, Institute for Cancer Research and Treatment, 10060 Candiolo, Turin, Italy.

出版信息

Cardiovasc Intervent Radiol. 2012 Feb;35(1):139-45. doi: 10.1007/s00270-011-0111-4. Epub 2011 Feb 9.

DOI:10.1007/s00270-011-0111-4
PMID:21305282
Abstract

PURPOSE

Percutaneous vertebroplasty (PV) is a minimally invasive procedure involving the injection of bone cement within a collapsed vertebral body. Although this procedure was demonstrated to be effective in osteoporosis and metastases, few studies have been reported in cases of multiple myeloma (MM). We prospectively evaluated the safety and efficacy of PV in the treatment of vertebral compression fractures (VCFs) resulting from MM.

MATERIALS AND METHODS

PV was performed in 106 consecutive MM patients who had back pain due to VCFs, the treatment of which had failed conservative therapies. Follow-up (28.2 ± 12.1 months) was evaluated at 7 and 15 days as well as at 1, 3, 6, 12, 18, and every 6 months after PV. Visual analog scale (VAS) pain score, opioid use, external brace support, and Oswestry Disability Index (ODI) score were recorded.

RESULTS

The median pretreatment VAS score of 9 (range 4-10) significantly (P < 0.001) decreased to 1 (range 0-9) after PV. Median pre-ODI values of 82% (range 36-89%) significantly improved to 7% (range 0-82%) (P < 0.001). Differences in pretreatment and posttreatment use of analgesic drug were statistically significant (P < 0.001). The majority of patients (70 of 81; 86%) did not use an external brace after PV (P < 0.001).

CONCLUSION

PV is a safe, effective, and long-lasting procedure for the treatment of vertebral compression pain resulting from MM.

摘要

目的

经皮椎体成形术(PV)是一种微创介入技术,通过向塌陷的椎体中注入骨水泥来治疗骨质疏松症和转移瘤所致的椎体压缩性骨折。然而,目前仅有少数研究报道了该技术治疗多发性骨髓瘤(MM)所致椎体压缩性骨折的疗效。本研究前瞻性评估了经皮椎体成形术治疗 MM 所致椎体压缩性骨折的安全性和疗效。

材料与方法

106 例 MM 患者因椎体压缩性骨折导致背痛,且保守治疗失败,接受了经皮椎体成形术治疗。术后随访 28.2±12.1 个月,在术后 7、15 天及 1、3、6、12、18 个月和此后每 6 个月评估视觉模拟评分(VAS)疼痛评分、阿片类药物使用、外固定支具支持和 Oswestry 功能障碍指数(ODI)评分。

结果

术前 VAS 评分为 9(4-10)分,治疗后显著降低至 1(0-9)分(P<0.001)。术前 ODI 为 82%(36-89%),治疗后显著改善至 7%(0-82%)(P<0.001)。术前和术后镇痛药使用的差异有统计学意义(P<0.001)。70 例患者(81 例中的 70 例,86%)在接受经皮椎体成形术后不再使用外固定支具(P<0.001)。

结论

经皮椎体成形术是治疗 MM 所致椎体压缩性疼痛的一种安全、有效且持久的方法。

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