Guthrie Clinic-Big Flats, 31 Arnot Road, Horseheads, NY 14845, USA.
Pain Med. 2012 Feb;13(2):198-203. doi: 10.1111/j.1526-4637.2011.01299.x. Epub 2012 Jan 13.
Skeletal metastases can cause severe pain and functional impairment, secondary to direct invasion or osteolysis. Direct palliation of these metastases can reduce the burden of pain. Surgical excision or radiotherapy has been used to target these tumors. In precarious locations, such as the sternum, surgery may lead to significant morbidity. Radiotherapy requires multiple visits, which may be difficult for the severely disabled. Minimally invasive, image-guided procedures are gaining wider acceptance in treating these lesions. Kyphoplasty has been used for vertebral column metastases. Osteoplasty of a metastasis to a flat, non-weight-bearing bone is rarely reported. The author reports the successful palliation of a sternal metastasis with kyphoplasty. Ultrasound imaging was used with fluoroscopy. Reproducibility, by other providers, is imperative with any emerging technique; this will facilitate wider patient access and device innovation. Hopefully, future multicenter trials will validate the efficacy and safety of this technique.
骨骼转移可因直接侵犯或溶骨性破坏导致严重疼痛和功能障碍。直接缓解这些转移灶可减轻疼痛负担。手术切除或放疗已被用于治疗这些肿瘤。在胸骨等不稳定位置，手术可能导致严重的发病率。放疗需要多次就诊，这对于严重残疾患者可能较为困难。微创、影像引导的操作在治疗这些病变方面越来越被广泛接受。球囊扩张椎体后凸成形术已用于治疗脊柱转移。将骨转移到扁平、非承重骨的骨成形术很少有报道。作者报告了一例成功用球囊扩张椎体后凸成形术缓解胸骨转移的病例。该病例使用了超声成像和透视技术。任何新兴技术都需要其他提供者的可重复性，这将有助于更广泛的患者获得治疗和器械创新。希望未来的多中心试验将验证该技术的疗效和安全性。
