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新兴的微创经皮手术治疗髋臼周围溶骨性转移瘤。

Emerging Minimally Invasive Percutaneous Procedures for Periacetabular Osteolytic Metastases.

机构信息

Department of Orthopaedics and Rehabilitation, University of Mississippi Medical Center, Jackson, Mississippi.

Yale School of Medicine, Yale University, New Haven, Connecticut.

出版信息

J Bone Joint Surg Am. 2023 Mar 15;105(6):479-489. doi: 10.2106/JBJS.22.00694. Epub 2023 Jan 26.

Abstract

➤: Periacetabular osteolytic skeletal metastases are frequently associated with pain and impaired ambulatory function. Minimally invasive techniques allow for the restoration of ambulation without interrupting critical systemic cancer therapy.

➤: The open surgical management of massive periacetabular osteolytic lesions, such as by curettage, internal fixation, or complex total hip reconstruction, is associated with blood loss, hospitalization, rehabilitation, and complications such as infection or delayed wound-healing.

➤: Minimally invasive percutaneous procedures have become increasingly popular for the management of periacetabular osteolytic metastases by interventional oncologists and orthopaedic surgeons before complex open surgical procedures are considered.

➤: Minimally invasive procedures may include various methods of cancer ablation and reinforcement techniques. Minimally invasive procedures may entail cancer ablation, polymethylmethacrylate (PMMA) cement reinforcement, balloon osteoplasty, percutaneous screw fixation, or combinations of the aforementioned techniques (e.g., ablation-osteoplasty-reinforcement-internal fixation [AORIF]).

摘要

➤:髋臼周围溶骨性骨转移常伴有疼痛和活动能力受损。微创技术可在不中断关键全身癌症治疗的情况下恢复活动能力。

➤:开放性手术治疗巨大的髋臼周围溶骨性病变,如刮除术、内固定或复杂的全髋关节重建术,与失血、住院、康复以及感染或伤口愈合延迟等并发症相关。

➤:介入肿瘤科医生和骨科医生在考虑复杂的开放性手术之前,越来越多地采用微创经皮手术来治疗髋臼周围溶骨性转移瘤。

➤:微创操作可能包括各种癌症消融方法和强化技术。微创操作可能包括癌症消融、聚甲基丙烯酸甲酯(PMMA)水泥强化、球囊骨成形术、经皮螺钉固定,或上述技术的组合(例如,消融-骨成形术-强化-内固定 [AORIF])。

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