Department of Diagnostic and Interventional Radiology, Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China.
Korean J Radiol. 2019 Jun;20(6):939-946. doi: 10.3348/kjr.2018.0803.
To report our initial experience of percutaneous sacroplasty (PSP) with an interpedicular approach for treating painful sacral metastases involving multiple sacral vertebral bodies.
This study prospectively enrolled 10 consecutive patients (six men and four women; mean age, 56.3 ± 13.8 years) who underwent PSP for painful sacral metastases involving multiple sacral vertebral bodies from March 2017 to September 2018. Visual analogue scale (VAS) scores, Oswestry disability index (ODI) values, and the number of opioids prescribed to the patients were assessed before and after PSP. The procedure duration, length of hospitalization, and complications were also recorded.
Mean VAS and ODI declined significantly from 6.90 ± 1.20 and 74.40 ± 5.48 before the procedure to 2.70 ± 1.34 and 29.60 ± 14.57 after the procedure, respectively ( < 0.01). The median number of opioids prescribed per patient decreased from 2 (interquartile range [IQR] 1-3) pre-procedure to 1 (IQR 0-3) post-procedure ( < 0.01). Nine of the 10 patients showed no or decreased opioid usage, and only 1 patient showed unchanged usage. The mean procedure duration was 48.5 ± 3.0 minutes. The average length of hospitalization was 4.7 ± 1.7 days. Extraosseous cement leakage occurred in three cases without causing any clinical complications.
PSP with an interpedicular approach is a safe and effective treatment in patients with painful sacral metastases involving multiple sacral vertebral bodies and can relieve pain and improve mobility.
报告我们采用经椎弓根入路经皮骶骨成形术(PSP)治疗累及多个骶骨椎体的疼痛性骶骨转移的初步经验。
本研究前瞻性纳入了 2017 年 3 月至 2018 年 9 月期间因累及多个骶骨椎体的疼痛性骶骨转移而行 PSP 的 10 例连续患者(男 6 例,女 4 例;平均年龄 56.3±13.8 岁)。分别于 PSP 前后评估患者的视觉模拟量表(VAS)评分、Oswestry 残疾指数(ODI)值和开具的阿片类药物数量。记录手术时间、住院时间和并发症。
VAS 和 ODI 评分分别从 PSP 前的 6.90±1.20 和 74.40±5.48 显著下降至 PSP 后的 2.70±1.34 和 29.60±14.57(<0.01)。每名患者开具的阿片类药物数量中位数从 PSP 前的 2(四分位距 [IQR] 1-3)减少至 PSP 后的 1(IQR 0-3)(<0.01)。10 例患者中有 9 例无或减少了阿片类药物的使用,仅有 1 例保持不变。手术时间平均为 48.5±3.0 分钟。平均住院时间为 4.7±1.7 天。3 例出现骨外水泥渗漏,但无任何临床并发症。
采用经椎弓根入路的 PSP 治疗累及多个骶骨椎体的疼痛性骶骨转移是一种安全有效的治疗方法,可缓解疼痛并提高活动能力。