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李磊本,张昌盛,赵军红,张福华.经皮椎体成形术联合肿瘤介入摘除术治疗转移瘤导致的椎体压缩性骨折[J].脊柱外科杂志,2020,18(4):248-252.
经皮椎体成形术联合肿瘤介入摘除术治疗转移瘤导致的椎体压缩性骨折     点此下载全文 (Fulltext)
李磊本1  张昌盛2  赵军红1  张福华1
1. 中国人民解放军陆军第八十三集团军医院脊柱外科, 新乡 453000;
2. 洛阳正骨医院脊柱微创外科, 洛阳 471000
基金项目:
DOI:10.3969/j.issn.1672-2957.2020.04.007
摘要点击次数: 710
全文下载次数: 207
摘要:
      目的 探究经皮椎体成形术(PVP)联合肿瘤介入摘除术(ITR)治疗转移瘤导致的椎体压缩性骨折的疗效,并评价其安全性。方法 2014年1月—2017年6月收治中国人民解放军陆军第八十三集团军医院转移瘤导致的椎体压缩性骨折患者共94例,其中49例采用PVP治疗(PVP组),45例采用PVP联合ITR治疗(PVP+ITR组)。记录2组患者的骨水泥注射量及骨水泥渗漏情况,观察神经功能障碍及感染等并发症发生情况,采用疼痛视觉模拟量表(VAS)评分评价疼痛改善情况。结果 所有手术顺利完成,所有患者随访超过12个月。PVP组骨水泥注射量为(3.12±0.67)mL,PVP+ITR组为(5.33±1.67)mL,差异有统计学意义(P<0.05)。PVP组骨水泥渗漏率为48.98%,PVP+ITR组为20.75%,差异有统计学意义(P<0.05)。2组患者术后VAS评分均较术前改善,且术后1、3、6、12个月PVP+ITR组VAS评分优于PVP组,差异均有统计学意义(P<0.05)。2组患者术后均未见神经功能障碍及感染等并发症发生。结论 PVP联合ITR治疗转移瘤导致的椎体压缩性骨折能够有效维持椎体稳定,减少骨水泥渗漏的发生,有效缓解疼痛,具有临床应用价值。
关键词:胸椎  腰椎  肿瘤转移  骨折,压缩性  骨质疏松  导管消融术  椎体成形术
Percutaneous vertebroplasty combined with interventional tumor removal in treatment of vertebral compression fracture caused by metastatic tumor    Fulltext
LI Lei-ben1  ZHANG Chang-sheng2  ZHAO Jun-hong1  ZHANG Fu-hua1
1. Department of Spinal Surgery, Army 83 rd Group Military Hospital of Chinese PLA, Xinxiang 453000, Henan, China;
2. Department of Spinal Minimally Invasive Surgery, Luoyang Bone-setting Hospital, Luoyang 471000, Henan, China
Fund Project:
Abstract:
      Objective To explore the effect and safety of percutaneous vertebroplasty(PVP) combined with interventional tumor removal(ITR) on the treatment of vertebral compression fracture caused by metastatic tumor. Methods From January 2014 to June 2017,94 patients with vertebral compression fracture caused by metastatic tumor at Army 83rd Group Military Hospital of Chinese PLA were selected,of whom 49 were treated with PVP(PVP group) and 45 were treated with PVP combined with ITR(PVP+ITR group). The injection amount of bone cement and leakage of bone cement were recorded. The occurrence of complications such as neurological dysfunction and infection were observed. The improvement of pain was evaluated by pain visual analogue scale(VAS) score. Results All the operations were successfully completed. All the patients were followed up for more than 12 months. The injection amount of bone cement was (3.12±0.67)mL in PVP group and (5.33±1.67)mL in PVP+ITR group,and the difference was statistically significant(P<0.05). The leakage rate of bone cement was 48.98% in PVP group and 20.75% in PVP+ITR group,and the difference was statistically significant(P<0.05). The VAS score of PVP+ITR group was better than that of PVP group at 1,3,6,12 months postoperatively,and differences were all statistically significant(P<0.05). No complications such as neurological dysfunction and infection were found in the 2 groups. Conclusion PVP combined with ITR in the treatment of vertebral compression fracture caused by metastatic tumor can effectively maintain the stability of the vertebral body,prevent bone cement leakage,and releve the pain,being of clinical application value.
Keywords:Thoracic vertebrae  Lumbar vertebrae  Neoplasm metastasis  Fractures,compression  Osteoporosis  Catheter ablation  Vertebroplasty
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