Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, People's Republic of China.
Radiology, Clinical Medical of Shanghai Tenth People's Hospital of Nanjing Medical University, Yanchang Road 301#, Shanghai, China.
Skeletal Radiol. 2022 Mar;51(3):565-571. doi: 10.1007/s00256-021-03788-7. Epub 2021 Jul 10.
To investigate the safety and efficacy of the combination of radiofrequency ablation (RFA) and vertebroplasty versus single vertebroplasty in treating spinal metastases.
The data of 35 patients with vertebral neoplastic lesions who received RFA combined with vertebroplasty (group A, 15 patients with 17 lesions) or single vertebroplasty (group B, 20 patients with 24 lesions) from March 2016 to June 2019 were retrospectively compared. The data of patients' Visual Analogue Scale (VAS) scores prior to the treatments, 1 week, 1 month, 3 months, and 6 months after the treatments, injected cement volume, ratios of cement leakage were compared between the two groups.
All procedures were successfully done without severe complications. The VAS scores in group A were decreased more rapidly 1 week after the treatments and remained more stable at 6 months than that in group B (P < 0.05). The cement injected in group A (5.95 ± 1.45 mL, range 4-9.5 mL) was significantly more than that in group B (4.09 ± 0.55 mL, range 3.1-5.5 mL) (P < 0.05). The ratio of vascular cement leakage in group A was significantly lower than that in group B (P < 0.05), while no statistical difference was found in the non-vascular cement leakage (P > 0.05).
Our study shows that the combination of RFA and vertebroplasty has a better analgesic effect with more injected cement and lower rates of venous cement leakage than single vertebroplasty.
探讨射频消融(RFA)联合椎体成形术与单纯椎体成形术治疗脊柱转移瘤的安全性和疗效。
回顾性比较了 2016 年 3 月至 2019 年 6 月收治的 35 例接受 RFA 联合椎体成形术(A 组,15 例 17 个病灶)或单纯椎体成形术(B 组,20 例 24 个病灶)治疗的脊柱肿瘤患者的资料。比较两组患者治疗前、治疗后 1 周、1 个月、3 个月和 6 个月的视觉模拟量表(VAS)评分、注射水泥量、水泥渗漏率。
所有手术均顺利完成,无严重并发症。治疗后 1 周,A 组 VAS 评分下降更快,6 个月时更稳定,优于 B 组(P < 0.05)。A 组(4-9.5 ml,平均 5.95±1.45 ml)注射水泥量明显多于 B 组(3.1-5.5 ml,平均 4.09±0.55 ml)(P < 0.05)。A 组血管性水泥渗漏率明显低于 B 组(P < 0.05),而非血管性水泥渗漏率无统计学差异(P > 0.05)。
本研究表明,与单纯椎体成形术相比,RFA 联合椎体成形术具有更好的镇痛效果,注射水泥量更多,静脉性水泥渗漏率更低。