Liu Qingshan, He Yuanliang, Lei Xi, Yan Jun, Feng Wei, He Chengchui, Huang Xuemei, Cao Dan, Dong Yingchun, Li Dingding
Department of Orthopaedics, The First People's Hospital of Longquanyi District, Chengdu, China.
Clin Spine Surg. 2025 Apr 1;38(3):E193-E199. doi: 10.1097/BSD.0000000000001700. Epub 2024 Oct 14.
Review of mesh-container plasty (MCP) in osteolytic vertebral metastases.
This study aims to assess the efficacy and safety of MCP in treating advanced vertebral metastases with posterior wall defects.
Diagnosis of vertebral metastases typically relies on the patient's tumor history, bone scans, or vertebral MRI. Surgical intervention often involves sampling vertebral body tissue for pathologic diagnosis. The revised Tokuhashi score is commonly used to predict survival time in patients with bone metastases. Outcome evaluation frequently employs the visual analog scale (VAS) and the Oswestry disability index (ODI) in assessing spinal surgery outcomes.
A retrospective analysis included 111 patients treated between January 2014 and January 2018 in our hospital. Patients were categorized into 2 groups: MCP group (n=51) and PVP group (n=60). Grades based on the percentage of posterior wall defect area were established: grade I (≤25%), grade II (26% to 50%), grade III (51% to 75%), and grade IV (76% to 100%). Efficacy was assessed using VAS and ODI.
Both MCP and PVP groups exhibited significant pain relief and improved motor function. No significant differences were observed in VAS and ODI scores at any follow-up point ( P >0.05). In the MCP group, bone cement leakage occurred in 13 cases, with a leakage rate of 25.49%. However, none of the patients experienced clinical or neurological symptoms. In the PVP group, bone cement leakage occurred in 50% of patients, with 6 patients developing neurological symptoms. Significant differences between the groups were observed in major complications related to bone cement leakage ( P =0.03).
MCP demonstrates efficacy in pain relief and safety in treating vertebral metastases with deficient posterior walls. It represents a promising option for spinal surgeons managing vertebral metastases with posterior wall deficiencies.
溶骨性椎体转移瘤的网袋成形术（MCP）回顾。
本研究旨在评估MCP治疗伴有后壁缺损的晚期椎体转移瘤的疗效和安全性。
椎体转移瘤的诊断通常依赖于患者的肿瘤病史、骨扫描或椎体磁共振成像（MRI）。手术干预通常包括获取椎体组织进行病理诊断。修订的Tokuhashi评分常用于预测骨转移患者的生存时间。结果评估通常采用视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）来评估脊柱手术的结果。
回顾性分析2014年1月至2018年1月在我院接受治疗的111例患者。患者分为两组：MCP组（n = 51）和经皮椎体成形术（PVP）组（n = 60）。根据后壁缺损面积百分比划分等级：I级（≤25%），II级（26%至50%），III级（51%至75%），IV级（76%至100%）。使用VAS和ODI评估疗效。
MCP组和PVP组均显示出明显的疼痛缓解和运动功能改善。在任何随访时间点，VAS和ODI评分均未观察到显著差异（P>0.05）。MCP组有13例发生骨水泥渗漏，渗漏率为25.49%。然而，所有患者均未出现临床或神经症状。PVP组有50%的患者发生骨水泥渗漏，6例出现神经症状。两组在与骨水泥渗漏相关的主要并发症方面存在显著差异（P = 0.03）。
MCP在缓解伴有后壁缺损的椎体转移瘤疼痛方面显示出疗效，且安全性良好。它是脊柱外科医生治疗伴有后壁缺损的椎体转移瘤的一个有前景的选择。
