Yang Yue, Tian Qinghua, Wang Dan, Yi Fei, Song Hongmei, Li Wenbin, Wu Chungen
Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.
J Pain Res. 2021 Jul 13;14:2121-2128. doi: 10.2147/JPR.S318236. eCollection 2021.
To report our experience of treating painful C1 osteolytic lesions with cement augmentation via a lateral approach under fluoroscopic guidance.
Nine consecutive patients (eight men and one woman; mean age: 56.7±13.2 years) with osteolytic lesions of the atlas who underwent cementoplasty via a lateral approach were enrolled in this study. The technical success rate, operation time, and complications were recorded. Visual analogue scale (VAS) and Neck disability index (NDI) were used to evaluate the pain relief and neck function status pre-procedure (baseline) and post-procedure (at 3 days; after 1, 3, 6, 12, 18, and 24 months; and at the last follow-up).
The procedure was technically successful without any complications in all patients. The mean procedure time was 44.3±7.8 min. There were three cases of bone cement leakage, but no clinical symptoms. The mean VAS score decreased from 6.7±1.0 before the procedure to 3.7 three days after the procedure. The mean NDI score decreased from 67.3±11.2 before the procedure to 39.3±13.7 three days after the procedure. The VAS and NDI scores decreased at each follow-up time point, and the difference was statistically significant compared with the scores before the procedure (P<0.01).
Fluoroscopy-guided lateral approach is a feasible, safe, and effective method for treatment of osteolytic lesions of the atlas and can relieve pain and stabilize the bone.
报告我们在透视引导下经外侧入路使用骨水泥强化治疗C1溶骨性病变的经验。
本研究纳入了9例连续的经外侧入路行骨水泥成形术治疗寰椎溶骨性病变的患者（8例男性，1例女性；平均年龄：56.7±13.2岁）。记录技术成功率、手术时间及并发症。采用视觉模拟评分法（VAS）和颈部功能障碍指数（NDI）评估术前（基线）及术后（术后3天；术后1、3、6、12、18和24个月；以及末次随访时）的疼痛缓解情况和颈部功能状态。
所有患者手术技术均成功，无任何并发症。平均手术时间为44.3±7.8分钟。有3例骨水泥渗漏，但无临床症状。平均VAS评分从术前的6.7±1.0降至术后3天的3.7。平均NDI评分从术前的67.3±11.2降至术后3天的39.3±13.7。在每个随访时间点，VAS和NDI评分均下降，与术前评分相比差异有统计学意义（P<0.01）。
透视引导下经外侧入路是治疗寰椎溶骨性病变的一种可行、安全且有效的方法，可缓解疼痛并稳定骨质。
