Alfonso M, Llombart R, Gil L, Martinez I, Rodríguez C, Álvarez L, Gallego J
Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, Spain.
Departamento de Cirugía Ortopédica y Traumatología, Clínica Universidad de Navarra, Pamplona, Spain.
Rev Esp Cir Ortop Traumatol. 2023 Nov-Dec;67(6):S480-S486. doi: 10.1016/j.recot.2023.08.003. Epub 2023 Aug 3.
Treatment of metastatic vertebral fractures without neural compression is performed with percutaneous cementation techniques. The increase in intratumoral pressure by these techniques can send tumor cells into the bloodstream. To prevent this dissemination and improve pain treatment, ablation techniques have been introduced that would allow the creation of a cavity in the tumor prior to cementation or directly necrosing the metastasis when its size is small.
We present the experience with ablation of two hospitals and two different ablation techniques. The first group used radiofrequency ablation (A) in 14 patients (26 vertebrae), 4 of whom underwent vertebral arthrodesis. The second group used microwave ablation (B) in 93 patients (129 lesions) without associated vertebral instrumentation.
In group A pain improvement in VAS was 7.7-2.6 at 6 weeks. There were no complications derived from the ablation. In most cases cementation was associated. In the group B pain improvement in VAS went from 6.8 to 1.7 at 6 weeks. Cementation was associated in all cases. There were no complications derived from the ablation.
The association of ablation techniques with vertebral cementation is a safe technique that significantly improves the patient's pain and can help control the disease.
对于无神经受压的转移性椎体骨折,采用经皮骨水泥注入技术进行治疗。这些技术会使瘤内压力升高,从而将肿瘤细胞送入血液循环。为防止这种播散并改善疼痛治疗,已引入消融技术,该技术可在注入骨水泥之前在肿瘤内制造一个腔隙,或者在转移瘤较小时直接使其坏死。
我们介绍了两家医院采用两种不同消融技术的经验。第一组对14例患者(26个椎体)使用射频消融(A),其中4例接受了椎体融合术。第二组对93例患者(129个病灶)使用微波消融(B),未进行相关的椎体器械固定。
在A组中,6周时视觉模拟评分(VAS)的疼痛改善从7.7降至2.6。消融未引发并发症。在大多数情况下,均联合进行了骨水泥注入。在B组中,6周时VAS的疼痛改善从6.8降至1.7。所有病例均联合进行了骨水泥注入。消融未引发并发症。
消融技术与椎体骨水泥注入相结合是一种安全的技术,可显著改善患者疼痛并有助于控制疾病。