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使用脊柱撑开器植入物的经皮椎体成形术治疗多发性骨髓瘤患者椎体压缩骨折的再扩张:一项初步回顾性研究。

Re-expansion of vertebral compression fractures in patients with multiple myeloma with percutaneous vertebroplasty using spinejack implants: a preliminary and retrospective study.

作者信息

Pusceddu Claudio, Faiella Eliodoro, Derudas Daniele, Ballicu Nicola, Melis Luca, Zedda Stefano, Marsico Salvatore

机构信息

Division of Interventional Radiology, Department of Oncological Radiology, Ocological Hospital "A. Businco", Regional Referral Center for Oncologic Diseases, Cagliari, Italy.

Department of Radiology, Sant'Anna Hospital, San Fermo Della Battaglia, Italy.

出版信息

Front Surg. 2023 May 23;10:1121981. doi: 10.3389/fsurg.2023.1121981. eCollection 2023.

Abstract

OBJECTIVE

To retrospectively evaluate the feasibility and effectiveness of vertebroplasty using Spinejack implantation for the treatment and stabilization of painful vertebral compression fractures, in patients diagnosed with Multiple Myeloma (MM), to allow both an effective pain reduction and a global structural spine stabilization.

MATERIALS AND METHODS

From July 2017 and May 2022 thirty-nine patients diagnosed MM, with forty-nine vertebral compression fractures underwent percutaneous Vertebroplasty using Spinejack Implants. We analyzed the feasibility and complications of the procedure, the decrease in pain using visual analogue scale (VAS) and Functional Mobility Scale (FMS).

RESULTS

The technical success rate was 100%. No procedure-related major complications or death occurred. In the 6-month follow-up, the mean VAS score decreased from 5.4 ± 1.0 to 0.2 ± 0.5 with a mean reduction of 96.3%. FMS decreased from 2.3 ± 0.5 vs. 1.2 ± 0.4 with a mean reduction of -47.8%. There were no major complications related to incorrect positioning of the Expandable Titanium SpineJack Implants. In five patients, a cement leak was observed with no associated clinical manifestations. The average length of hospital stay was 6-8 Hours6.6 ± 1.2 h. No new bone fractures or local disease recurrence occurred during a median contrast-enhanced CT follow-up of 6 months.

CONCLUSIONS

Our results suggest that vertebroplasty, using Spinejack implantation for the treatment and stabilization of painful vertebral compression fractures, secondary to Multiple Myeloma is a safe and effective procedure with long - term pain relief and restoration of vertebral height.

摘要

目的

回顾性评估使用Spinejack植入物进行椎体成形术治疗和稳定多发性骨髓瘤(MM)患者疼痛性椎体压缩骨折的可行性和有效性,以实现有效的疼痛减轻和脊柱整体结构稳定。

材料与方法

2017年7月至2022年5月,39例诊断为MM的患者,共49处椎体压缩骨折,接受了使用Spinejack植入物的经皮椎体成形术。我们分析了该手术的可行性和并发症,使用视觉模拟量表(VAS)和功能活动量表(FMS)评估疼痛减轻情况。

结果

技术成功率为100%。未发生与手术相关的重大并发症或死亡。在6个月的随访中,平均VAS评分从5.4±1.0降至0.2±0.5,平均降低96.3%。FMS从2.3±0.5降至1.2±0.4,平均降低-47.8%。未发生与可膨胀钛制SpineJack植入物定位错误相关的重大并发症。5例患者观察到骨水泥渗漏,但无相关临床表现。平均住院时间为6 - 8小时6.6±1.2小时。在6个月的中位对比增强CT随访期间,未发生新的骨折或局部疾病复发。

结论

我们的结果表明,使用Spinejack植入物治疗和稳定多发性骨髓瘤继发的疼痛性椎体压缩骨折的椎体成形术是一种安全有效的手术,可实现长期疼痛缓解和恢复椎体高度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be00/10242080/4492d6c7dc62/fsurg-10-1121981-g001.jpg

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