Zhang Xusheng, Niu Jiacheng, Fan Jing, Hu Miaomiao, Xing Chao, Yuan Qianqian, Yang Shen, Wang Baohu, Li Peishun, Man Qirong, Ren Yanchen, Wu Linlin, Zhang Kaixian
Department of Oncology, Tengzhou Central People's Hospital Affiliated to Jining Medical College, Tengzhou, Shandong Province, People's Republic of China.
Medical Imaging Center, Tengzhou Central People's Hospital Affiliated to Jining Medical College, Tengzhou, Shandong Province, People's Republic of China.
J Pain Res. 2024 Aug 29;17:2823-2832. doi: 10.2147/JPR.S463266. eCollection 2024.
To evaluate the efficacy and safety of combined microwave ablation (MWA) and vertebral augmentation (VA) in the treatment of spinal metastases with posterior wall defects.
A retrospective review was conducted for 67 patients (42 men, 25 women) with painful spine metastases and posterior wall defects who underwent MWA combined with VA. Among these patients, 52 vertebrae had no epidural invasion and 33 had mild invasion but did not compress the spinal cord. Procedural effectiveness was determined by comparing visual analog scale (VAS) scores and Oswestry disability index (ODI) scores before the procedure and during the follow-up period.
The procedure was technically successful in all patients. The mean VAS score declined significantly from 6.85 ± 1.81 before the procedure to 3.27 ± 1.97 at 24 h, 1.96 ± 1.56 at 1 week, 1.84 ± 1.50 at 4 weeks, 1.73 ± 1.45 at 12 weeks, and 1.71 ± 1.52 at 24 weeks post-procedure (p < 0.01). The mean ODI score was lower post-procedure than before the procedure (p < 0.001). Transient nerve injury occurred in two patients (SIR classification D), and the incidence of asymptomatic bone cement (SIR classification A) was 43.5% (37/85).
MWA combined with VA is an effective and safe treatment for painful spine metastases with posterior wall defects.
评估微波消融（MWA）联合椎体强化（VA）治疗伴有后壁缺损的脊柱转移瘤的疗效和安全性。
对67例伴有疼痛性脊柱转移瘤且有后壁缺损的患者（42例男性，25例女性）进行回顾性研究，这些患者均接受了MWA联合VA治疗。其中，52个椎体无硬膜外侵犯，33个椎体有轻度侵犯但未压迫脊髓。通过比较术前及随访期间的视觉模拟评分（VAS）和奥斯维斯特功能障碍指数（ODI）来确定手术效果。
所有患者手术技术均成功。术后平均VAS评分从术前的6.85±1.81显著下降至术后24小时的3.27±1.97、1周时的1.96±1.56、4周时的1.84±1.50、12周时的1.73±1.45以及24周时的1.71±1.52（p<0.01）。术后平均ODI评分低于术前（p<0.001）。2例患者发生短暂性神经损伤（SIR分级D），无症状骨水泥渗漏发生率（SIR分级A）为43.5%（37/85）。
MWA联合VA是治疗伴有后壁缺损的疼痛性脊柱转移瘤的一种有效且安全的方法。
