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重新思考多转移患者的治疗策略:开放性后路融合术与经皮骨固定术治疗椎体转移瘤的综合回顾性分析

Rethinking Strategies for Multi-Metastatic Patients: A Comprehensive Retrospective Analysis on Open Posterior Fusion Versus Percutaneous Osteosynthesis in the Treatment of Vertebral Metastases.

作者信息

Scaramuzzo Laura, Perna Andrea, Velluto Calogero, Borruto Maria Ilaria, Gorgoglione Franco Lucio, Proietti Luca

机构信息

Department of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.

Department of Orthopaedics and Traumatology, Fondazione Casa Sollievo della Sofferenza IRCCS, 71013 San Giovanni Rotondo, Italy.

出版信息

J Clin Med. 2024 Jun 6;13(11):3343. doi: 10.3390/jcm13113343.

Abstract

Managing vertebral metastases (VM) is still challenging in oncology, necessitating the use of effective surgical strategies to preserve patient quality of life (QoL). Traditional open posterior fusion (OPF) and percutaneous osteosynthesis (PO) are well-documented approaches, but their comparative efficacy remains debated. This retrospective study compared short-term outcomes (6-12 months) between OPF and PO in 78 cancer patients with spinal metastases. This comprehensive evaluation included functional, clinical, and radiographic parameters. Statistical analysis utilized PRISM software (version 10), with significance set at < 0.05. PO demonstrated advantages over OPF, including shorter surgical durations, reduced blood loss, and hospital stay, along with lower perioperative complication rates. Patient quality of life and functional outcomes favored PO, particularly at the 6-month mark. The mortality rates at one year were significantly lower in the PO group. Minimally invasive techniques offer promising benefits in VM management, optimizing patient outcomes and QoL. Despite limitations, this study advocates for the adoption of minimally invasive approaches to enhance the care of multi-metastatic patients with symptomatic VM.

摘要

在肿瘤学领域,管理椎体转移瘤(VM)仍然具有挑战性,因此需要采用有效的手术策略来维持患者的生活质量(QoL)。传统的开放后路融合术(OPF)和经皮骨固定术(PO)是有充分文献记载的方法,但它们的相对疗效仍存在争议。这项回顾性研究比较了78例脊柱转移瘤癌症患者接受OPF和PO后的短期结局(6 - 12个月)。这项全面评估包括功能、临床和影像学参数。统计分析使用PRISM软件(版本10),显著性设定为<0.05。PO显示出优于OPF的优势,包括手术时间更短、失血减少、住院时间缩短,以及围手术期并发症发生率更低。患者的生活质量和功能结局更倾向于PO,尤其是在6个月时。PO组的一年死亡率显著更低。微创技术在VM管理中具有显著优势,可优化患者结局和生活质量。尽管存在局限性,但本研究主张采用微创方法来改善有症状VM的多发转移患者的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f6b/11173164/37b70288f2b7/jcm-13-03343-g001.jpg

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