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球囊椎体后凸成形术和椎体成形术如何影响多发性骨髓瘤脊柱转移患者的生活质量?

How do vertebroplasty and kyphoplasty affect the quality of life of patients with multiple myeloma spinal metastasis?

机构信息

Dr Ersin Arslan Education and Research Hospital Gaziantep, Gaziantep, Turkey.

Department of Orthopedic Surgery, Gaziantep University Hospital Gaziantep, Gaziantep, Turkey.

出版信息

Eur J Orthop Surg Traumatol. 2020 Dec;30(8):1447-1451. doi: 10.1007/s00590-020-02721-3. Epub 2020 Jun 26.

Abstract

BACKGROUND

Metastatic spinal lesions are diseases that impair the quality of life and require early diagnosis and treatment. The count of spinal metastasis patients rises day by day. Increased life expectancy has increased the incidence of cancer, making metastases more observable. The aim of our study was to investigate how the quality of life is affected in the patient group with vertebral fracture due to spinal metastases of multiple myeloma and undergoing vertebroplasty and kyphoplasty.

MATERIALS AND METHODS

Forty-two patients with fracture due to spinal metastasis and adequate follow-up between the years of 2011 and 2018 were included in the study. Patients were listed according to their primary malignancy and metastases. The effect of vertebroplasty and kyphoplasty was investigated by evaluating preoperative and postoperative VAS and Oswestry Disability Index scores. All patients' radiographic kyphosis angle, compression ratio and wedging index were calculated before operation and after operation.

RESULTS

A total of 76 vertebrae were operated in 42 patients. Significant differences were found in the comparison of preoperative and postoperative quality of life according to VAS and Oswestry Disability Index scores in the patients undergoing vertebroplasty, kyphoplasty or both procedures after spinal metastases (VAS; p = 0.0001, ODI; p = 0.002/0.0001). There were statistically significant differences in preoperative local kyphosis angle, compression ratio and wedging index and post-op local kyphosis angle, compression ratio and wedging index (p = 0.001).

CONCLUSION

Vertebroplasty and kyphoplasty, minimally invasive procedures performed after spinal metastases, improve the quality of life of the patients.

摘要

背景

转移性脊柱病变会降低生活质量,需要早期诊断和治疗。患有脊柱转移瘤的患者数量日益增加。预期寿命的延长增加了癌症的发病率,使转移瘤更为明显。我们的研究目的是调查多发性骨髓瘤脊柱转移导致脊柱骨折并接受椎体成形术和后凸成形术的患者群体的生活质量受到何种影响。

材料和方法

本研究纳入了 2011 年至 2018 年间因脊柱转移导致骨折且有足够随访的 42 例患者。根据主要恶性肿瘤和转移部位对患者进行分类。通过评估术前和术后的视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)评分来研究椎体成形术和后凸成形术的效果。所有患者在术前和术后均计算了放射学后凸角、压缩比和楔变指数。

结果

在 42 例患者中,共对 76 个椎体进行了手术。接受椎体成形术、后凸成形术或两种手术的患者,术后 VAS 和 ODI 评分均较术前有显著改善(VAS:p=0.0001,ODI:p=0.002/0.0001)。术前和术后局部后凸角、压缩比和楔变指数有显著差异(p=0.001)。

结论

脊柱转移后进行的微创椎体成形术和后凸成形术可改善患者的生活质量。

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