He Shuangjun, Zhou Zhangzhe, Zhang Changhao, Lv Nanning, Qian Zhonglai, Sun Zhiyong
Department of Orthopedic Surgery, The People's Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Danyang, Jiangsu Province.
Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou.
Medicine (Baltimore). 2020 Jun 19;99(25):e20430. doi: 10.1097/MD.0000000000020430.
To compare the efficacy and safety of kyphoplasty (KP) in the treatment of occult metastatic vertebral tumors (OMVT) and non-occult metastatic vertebral tumors (MVT).From January 2013 to December 2017, 65 cases of occult metastatic vertebral tumors and 82 cases of metastatic vertebral tumors were selected and divided into 2 groups. After KP, they were followed up by a year of outpatient visits and telephone calls. The visual analogue scale (VAS) and Oswestry disability index (ODI) scores, the amount of bone cement injected, the change of vertebral height and the incidence of complications were recorded, compared and analyzed by SPSS software. t test was used to compare the differences between the same group of patients at different times and between the 2 groups of patients.In the OMVT group, the operation time was 24.52 ± 4.24 minutes, the fluoroscopy time was 10.18 ± 1.53 minutes and the volume of bone cement was 3.62 ± 0.93 ml. The VAS score decreased from 7.26 ± 01.08 preoperatively to 2.77 ± 0.93 postoperatively (P < .01). The ODI score decreased from 64.89 ± 9.05 preoperatively to 25.82 ± 4.63 postoperatively (P < .01). In the MVT group, the operation time was 26.63 ± 4.61 minutes, the fluoroscopy time was 11.04 ± 2.15 minutes and the volume of bone cement was 4.09 ± 1.10 ml. The VAS score decreased from 7.73 ± 0.94 preoperatively to 3.22 ± 0.80 postoperatively (P < .01). The ODI score decreased from 69.20 ± 7.14 preoperatively to 28.02 ± 4.40 postoperatively (P < .01). The vertebral height of MVT patients was significantly improved after operation (P < .01), but there was no difference in OMVT patients (P > .05).Occult metastatic vertebral tumors can be detected by Magnetic Resonance Imaging (MRI), and KP may be more effective and safer in the treatment of OMVT.
比较椎体后凸成形术（KP）治疗隐匿性转移性椎体肿瘤（OMVT）和非隐匿性转移性椎体肿瘤（MVT）的疗效和安全性。2013年1月至2017年12月，选取65例隐匿性转移性椎体肿瘤患者和82例转移性椎体肿瘤患者，分为2组。行KP术后，通过门诊随访和电话随访1年。记录视觉模拟评分（VAS）和Oswestry功能障碍指数（ODI）评分、骨水泥注入量、椎体高度变化及并发症发生率，采用SPSS软件进行比较和分析。采用t检验比较同一组患者不同时间及两组患者之间的差异。OMVT组手术时间为24.52±4.24分钟，透视时间为10.18±1.53分钟，骨水泥用量为3.62±0.93ml。VAS评分术前为7.26±1.08，术后降至2.77±0.93（P＜0.01）。ODI评分术前为64.89±9.05，术后降至25.82±4.63（P＜0.01）。MVT组手术时间为26.63±4.61分钟，透视时间为11.04±2.15分钟，骨水泥用量为4.09±1.10ml。VAS评分术前为7.73±0.94，术后降至3.22±0.80（P＜0.01）。ODI评分术前为69.20±7.14，术后降至28.02±4.40（P＜0.01）。MVT患者术后椎体高度明显改善（P＜0.01），而OMVT患者无差异（P＞0.05）。隐匿性转移性椎体肿瘤可通过磁共振成像（MRI）检测到，KP治疗OMVT可能更有效、更安全。
