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经皮椎体后凸成形术联合经皮微波消融术对脊柱转移瘤患者疼痛及临床疗效的影响

Effect of percutaneous kyphoplasty combined with percutaneous microwave ablation on pain and clinical outcome in patients with spinal metastases.

作者信息

Bai Mei, Wang Hailin, Li Aoran, Zhang Tingting

机构信息

Department of Pain, Yancheng No. 1 People's Hospital, Afiliated Hospital of Medical School, Nanjing University, (The First People's Hospital of Yancheng), No. 66, South Ren Min Road, Yancheng, Jiangsu, 224006, China.

出版信息

Eur Spine J. 2025 Feb;34(2):657-664. doi: 10.1007/s00586-024-08558-2. Epub 2024 Nov 22.

Abstract

OBJECTIVE

To study the effect of percutaneous kyphoplasty (PKP) combined with microwave ablation (MWA) on pain and clinical outcomes in patients with spinal metastases.

METHODS

Eighty-seven patients with spinal metastases were retrospectively collected and divided into the PKP group (40 cases), and PKP + MWA group (47 cases). The postoperative efficacy (Frankel grade classification) was assessed, and the height of the diseased vertebrae, pain indices [visual analogue scale (VAS) and analgesic use score (AUS)], dysfunction in daily activities [Oswestry disability index (ODI)], quality of life (quality of life scores for tumor patients), and physical status score [Eastern Cooperative Oncology Group performance status] were compared. The incidence rate of adverse events and the survival of both groups were also counted.

RESULTS

Postoperatively, the PKP + MWA group had a higher total effective rate than the PKP group (P < 0.05). Versus the PKP group, the PKP + MWA group showed improved recovery of vertebral height, lower VAS, AUS, and ODI scores, higher QLS, and better physical status (all P < 0.05). Postoperative adverse events were not significantly different between the two groups (P > 0.05). The disease-free survival rate and overall survival rate within 1 year were higher in the PKP + MWA group than in the PKP group (P < 0.05).

CONCLUSION

PKP combined with MWA elevates the height of the diseased vertebrae, alleviates the symptoms of pain and dysfunction, and promotes the quality of life and physical status in patients with spinal metastases.

摘要

目的

研究经皮椎体后凸成形术(PKP)联合微波消融(MWA)对脊柱转移瘤患者疼痛及临床疗效的影响。

方法

回顾性收集87例脊柱转移瘤患者,分为PKP组(40例)和PKP+MWA组(47例)。评估术后疗效(Frankel分级),比较病椎高度、疼痛指标[视觉模拟评分法(VAS)和镇痛药物使用评分(AUS)]、日常活动功能障碍[Oswestry功能障碍指数(ODI)]、生活质量(肿瘤患者生活质量评分)及身体状况评分[东部肿瘤协作组体能状态评分]。同时统计两组不良事件发生率及生存率。

结果

术后,PKP+MWA组总有效率高于PKP组(P<0.05)。与PKP组相比,PKP+MWA组病椎高度恢复更好,VAS、AUS及ODI评分更低,QLS更高,身体状况更佳(均P<0.05)。两组术后不良事件差异无统计学意义(P>0.05)。PKP+MWA组1年内无病生存率和总生存率高于PKP组(P<0.05)。

结论

PKP联合MWA可提高病椎高度,缓解疼痛及功能障碍症状,改善脊柱转移瘤患者生活质量及身体状况。

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