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经皮椎体成形术治疗脊柱转移瘤的有效性和安全性

Effectiveness and safety of percutaneous vertebroplasty in the treatment of spinal metastatic tumor.

作者信息

Liu Yilin, Wang Yuqiang, Zhao Liang, Song Ruipeng, Tan Hongyu, Wang Limin

机构信息

Yilin Liu, Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou450052, China.

Yuqiang Wang, Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou450052, China.

出版信息

Pak J Med Sci. 2017 May-Jun;33(3):675-679. doi: 10.12669/pjms.333.12276.

Abstract

OBJECTIVE

To evaluate the effectiveness, safety and feasibility of percutaneous vertebroplasty in the treatment of spinal metastatic tumor.

METHODS

Thirty-four patients with spinal metastatic tumor who received treatment in the First Affiliated Hospital of Zhengzhou University from May 2014 to June 2015 were selected. Totally fifty diseased vertebrae were treated by percutaneous vertebroplasty. The curative effects were evaluated according to visual analogue scale (VAS) score, Oswestry Dability Index (ODI) and dose of pain reliever. The leakage conditions of bone cement and clinical complications were observed. The patients were followed up for 3 to 12 months.

RESULTS

The average VAS score and ODI 24 h after treatment were much lower than those before treatment, and the difference had statistical significance (P<0.05). The average VAS score and ODI at different follow-up periods after treatment were not significantly different (P>0.05). During follow up, nine patients stopped taking pain reliever, the dose of 18 patients had obvious reduction, and 7 patients kept previous dose; the incidence of bone cement leakage was 38.25%. Six patients had fever after surgery, but recovered after expectant treatment; 2 patients felt uncomfortable in the right lower limbs, but relieved after expectant treatment.

CONCLUSION

Percutaneous vertebroplasty can relieve pain efficiently, improve the daily living ability, and significantly enhance the living quality of patients with spinal metastatic tumors, with small trauma and high safety.

摘要

目的

评估经皮椎体成形术治疗脊柱转移瘤的有效性、安全性及可行性。

方法

选取2014年5月至2015年6月在郑州大学第一附属医院接受治疗的34例脊柱转移瘤患者。共对50个病椎行经皮椎体成形术治疗。根据视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)及止痛药物用量评估疗效。观察骨水泥渗漏情况及临床并发症。对患者进行3至12个月的随访。

结果

治疗后24小时平均VAS评分及ODI均明显低于治疗前,差异有统计学意义(P<0.05)。治疗后不同随访时间段的平均VAS评分及ODI差异无统计学意义(P>0.05)。随访期间,9例患者停用止痛药物,18例患者用药剂量明显减少,7例患者维持原剂量;骨水泥渗漏发生率为38.25%。6例患者术后发热,经保守治疗后恢复;2例患者右下肢不适,经保守治疗后缓解。

结论

经皮椎体成形术能有效缓解疼痛,提高日常生活能力,显著提高脊柱转移瘤患者的生活质量,且创伤小、安全性高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8ba/5510125/e091cb992d89/PJMS-33-675-g001.jpg

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