Bao Li, Jia Pu, Li Jinjun, Chen Hao, Dong Yipeng, Feng Fei, Yang He, Chen Mengmeng, Tang Hai
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Pain Res Manag. 2017;2017:3926318. doi: 10.1155/2017/3926318. Epub 2017 Jan 23.
Percutaneous vertebroplasty (PVP) has been shown to release spinal pain and stabilize the vertebral body. PVP is suggested as an alternative treatment in spinal metastasis. Although cervical metastases is less prevalent than thoracic and lumbar spine, PVP procedure in cervical vertebrae remains technical challenging. We retrospectively analyzed the data from patients ( = 9) who underwent PVP using anterolateral approach to treat severe neck pain and restricted cervical mobility from metastatic disease. Patients were rated using modified Tokuhashi score and Tomita score before the procedure. Visual analog scale (VAS), neck disability index (NDI), analgesic use, and imaging (X-ray or CT) were evaluated before PVP and 3 days, 3 months, and 6 months after PVP. All patients were in late stage of cancer evaluated using modified Tokuhashi and Tomita score. The cement leakage rate was 63.6% (14 of the 22 vertebrae) with no severe complications. VAS, NDI, and analgesic use were significantly decreased 3 days after the procedure and remained at low level until 6 months of follow-up. Our result suggested PVP effectively released the pain from patients with cervical metastasis. The results warrant further clinical investigation.
经皮椎体成形术（PVP）已被证明可缓解脊柱疼痛并稳定椎体。PVP被建议作为脊柱转移瘤的一种替代治疗方法。尽管颈椎转移瘤的发生率低于胸椎和腰椎，但颈椎的PVP手术在技术上仍具有挑战性。我们回顾性分析了9例采用前外侧入路进行PVP治疗因转移性疾病导致严重颈部疼痛和颈椎活动受限患者的数据。术前使用改良Tokuhashi评分和Tomita评分对患者进行评估。在PVP术前以及术后3天、3个月和6个月评估视觉模拟量表（VAS）、颈部功能障碍指数（NDI）、镇痛药物使用情况以及影像学检查（X线或CT）。所有患者根据改良Tokuhashi和Tomita评分评估均处于癌症晚期。骨水泥渗漏率为63.6%（22个椎体中的14个），无严重并发症。术后3天VAS、NDI和镇痛药物使用情况显著下降，并在随访6个月时一直维持在较低水平。我们的结果表明PVP能有效缓解颈椎转移瘤患者的疼痛。这些结果值得进一步的临床研究。
