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射频消融和骨水泥成形术在增强骨盆恶性骨转移患者功能能力方面的疗效。

Effectiveness of RF ablation and cementoplasty in enhancing functional capacity in pelvic malignant bone metastases.

机构信息

Sincan Training and Research Hospital, Sincan, 06934, Ankara, Turkey.

Department of Orthopaedics and Traumatology, Faculty of Medicine, Hacettepe University, Altindag, 06230, Ankara, Turkey.

出版信息

Eur J Orthop Surg Traumatol. 2024 Oct;34(7):3609-3618. doi: 10.1007/s00590-024-04081-8. Epub 2024 Aug 21.

Abstract

PURPOSE

Pelvic and sacral bone metastases cause significant morbidity. The primary aim of the study is to thoroughly evaluate the increase in functional capacity resulting from combined RF ablation and cementoplasty surgery applied to malignant bone metastases of the pelvic bones.

METHODS

Twenty patients who underwent RF ablation and cementoplasty for malign pelvic bone and sacrum metastases between January 2014 and December 2021 were retrospectively identified. The inclusion criteria were having a life expectancy of more than 1 month, being > 18 years old, and having at least 1 month of follow-up. The Visual Anlogue Scale (VAS) pain, Karnofsky Performance Status (KP), and Musculoskelatal Tumor Society (MSTS) scores were calculated.

RESULTS

VAS pain values decreased, and KP values increased postoperatively (p = 0.006 and p = 0,013). There was no statistically significant increase in MSTS (p > 0.05). The correlation relationships between lesion filling ratio and VAS pain, KP, and MSTS scores were not statistically significant (p > 0.05). Cement leakage was observed in 5 patients (25.0%), and no symptoms related to this leakage were observed.

CONCLUSION

The pelvic region, given its close proximity to blood vessels, nerves, and joint areas, along with the distinct challenges associated with its surgery, requires separate evaluation. In studies evaluating applications in the isolated pelvic ring region, as in our study, functional gains have been most comprehensively assessed in this study, demonstrating that the procedure results in significant functional improvements.

摘要

目的

骨盆和骶骨转移导致明显的发病率。本研究的主要目的是全面评估 RF 消融联合骨水泥成形术治疗骨盆恶性骨转移后功能能力的提高。

方法

回顾性分析 2014 年 1 月至 2021 年 12 月间因骨盆和骶骨恶性转移而行 RF 消融联合骨水泥成形术的 20 例患者。纳入标准为预期寿命超过 1 个月,年龄大于 18 岁,随访至少 1 个月。计算视觉模拟评分(VAS)疼痛、卡诺夫斯基表现状态(KPS)和肌肉骨骼肿瘤学会(MSTS)评分。

结果

术后 VAS 疼痛值降低,KPS 值升高(p=0.006 和 p=0.013)。MSTS 无统计学显著增加(p>0.05)。病灶填充率与 VAS 疼痛、KPS 和 MSTS 评分之间无统计学显著相关性(p>0.05)。5 例(25.0%)患者发生骨水泥渗漏,但无相关症状。

结论

骨盆区域靠近血管、神经和关节区域,手术难度大,需要单独评估。在评估单独骨盆环区域应用的研究中,如本研究,该手术在功能增益方面得到了最全面的评估,证明该手术可显著改善功能。

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