H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
J Natl Compr Canc Netw. 2012 Jun 1;10(6):715-9. doi: 10.6004/jnccn.2012.0074.
Cancer-related fractures of the spine are different from osteoporotic ones, not only in pathogenesis but also in natural history and treatment. Higher class evidence now supports offering balloon kyphoplasty to a patient with cancer, provided that the pain is significant in intensity, has a positional character, and correlates to the area of the fractured vertebrae. Absence of clinical spinal cord compression and overt instability are paramount. Because of the frequent disruption of the posterior vertebral body cortex in these patients, the procedure should be performed by experienced operators who could also quickly perform an open decompression if cement extravasation occurs. Patients will benefit from vertebral augmentation, even in chronic malignant fractures. A biopsy should be routinely performed and a combination with radiation treatment would be beneficial in most cases.
脊柱癌相关性骨折与骨质疏松性骨折不同，不仅在发病机制上，而且在自然病史和治疗上都不同。现在更高质量的证据支持为有疼痛且强度显著、有体位特征并与骨折椎体区域相关的癌症患者提供球囊椎体后凸成形术。无临床脊髓压迫和明显不稳定是至关重要的。由于这些患者经常出现后椎体皮质破裂，因此该手术应由经验丰富的操作人员进行，如果发生水泥外渗，他们也能迅速进行开放减压。即使是慢性恶性骨折，椎体增强也会使患者受益。应常规进行活检，大多数情况下，联合放射治疗将是有益的。
