Hariri Omid, Takayanagi Ariel, Miulli Dan E, Siddiqi Javed, Vrionis Frank
Department of Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, California, United States.
Department of Neurological Surgery, Marcus Neuroscience Institute, Boca Raton, Florida, United States.
Cureus. 2017 Mar 24;9(3):e1114. doi: 10.7759/cureus.1114.
Patients with metastatic spinal disease are affected by disabling pain. The treatment of spinal metastases is focused on pain reduction and improvement in quality of life. Until recently, many patients with metastatic spinal disease did not qualify as surgical candidates due to the risks of surgery and length of recovery period. However, recent advances in minimally invasive surgery such as kyphoplasty and vertebroplasty allow patients to safely undergo surgery for pain relief with a short recovery period. The studies reviewed here suggest that vertebral augmentation is successful in reducing pain and disability scores in patients with painful metastases and multiple myeloma and are a safe modality to provide lasting pain relief. As the use of kyphoplasty and vertebroplasty for treatment of vertebral metastases is becoming more common, new combinations of cement augmentation with other techniques such as percutaneous pedicle screws and radiofrequency ablation are being explored. The implementation of kyphoplasty and vertebroplasty, in conjunction with other minimally invasive surgical techniques as well as nonsurgical modalities, may lead to the best palliative management of cancer patients with spinal metastases and help them ultimately achieve a better quality of life.
患有转移性脊柱疾病的患者会受到致残性疼痛的影响。脊柱转移瘤的治疗重点在于减轻疼痛和提高生活质量。直到最近，由于手术风险和恢复期较长，许多患有转移性脊柱疾病的患者不符合手术条件。然而，诸如椎体后凸成形术和椎体成形术等微创手术的最新进展使患者能够安全地接受手术以缓解疼痛，且恢复期较短。此处回顾的研究表明，椎体强化术在降低伴有疼痛性转移瘤和多发性骨髓瘤患者的疼痛及残疾评分方面是成功的，并且是提供持久疼痛缓解的一种安全方式。随着椎体后凸成形术和椎体成形术用于治疗椎体转移瘤越来越普遍，正在探索骨水泥强化与其他技术（如经皮椎弓根螺钉和射频消融）的新组合。椎体后凸成形术和椎体成形术与其他微创手术技术以及非手术方式相结合的应用，可能会为患有脊柱转移瘤的癌症患者带来最佳的姑息治疗，并最终帮助他们实现更好的生活质量。
