Choi Eun-Seok, Kim Yong-Il, Kang Hyun Guy, Kim June Hyuk, Kim Han Soo, Lin Patrick P
Acta Orthop Belg. 2017 Sep;83(3):480-487.
The purpose of this study is to demonstrate the surgical technique and to show the results of percutaneous cementoplasty (PC) for acetabular metastases using lateral approach under regional anesthesia. Forty-two cases underwent PC for acetabular metastases. The PC was performed using spinal anesthesia, lateral approach and fluoroscopic guidance. We assessed visual analogue scale (VAS) and revised musculoskeletal tumor society (MSTS) rating system and maximum standardized uptake value (SUVmax) of the acetabular lesion using F-18-FDG PET/CT before and after the PC. The mean injected volume of polymethylmethacrylamide to the pelvis was 21±11.8 ml. The mean of regional VAS (6.2±1.1 vs. 3.1±2.7, p<0.001), MSTS (10.3±3.9 vs. 18.3±3.2, p<0.001) and local SUVmax (8.6±5.2 vs. 5.7±3.6 , p = 0.012) on PET/CT showed significant reductions after surgery. Twenty-three patients (55%) died of disease at mean 11.8±4.8 months after surgery. PC using lateral approach and regional anesthesia could be a simple and safe surgical method for relieving pain and maintaining skeletal stability against acetabular metastasis.
本研究的目的是展示手术技术，并呈现区域麻醉下经皮骨水泥成形术（PC）治疗髋臼转移瘤的结果。42例髋臼转移瘤患者接受了PC治疗。PC手术采用脊髓麻醉、外侧入路和透视引导。我们在PC术前和术后使用F-18-FDG PET/CT评估视觉模拟量表（VAS）、修订的肌肉骨骼肿瘤学会（MSTS）评分系统以及髋臼病变的最大标准化摄取值（SUVmax）。注入骨盆的聚甲基丙烯酸甲酯平均体积为21±11.8 ml。PET/CT上区域VAS均值（6.2±1.1对3.1±2.7，p<0.001）、MSTS均值（10.3±3.9对18.3±3.2，p<0.001）和局部SUVmax均值（8.6±5.2对5.7±3.6，p = 0.012）术后均显著降低。23例患者（55%）在术后平均11.8±4.8个月死于疾病。采用外侧入路和区域麻醉的PC可能是一种简单、安全的手术方法，可缓解疼痛并维持针对髋臼转移瘤的骨骼稳定性。
