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Clnical Study of the Treatment of Patients with a Metastatic Spinal Tumor by Percutaneous Vertebroplasty under the Guidance of DSA
作者姓名:Zuozhang  Yang  Jianbo  Xu  Congguo  Jin  Pengiie  Liu  Tao  Yuan  Baosheng  Qian  Jinyu  Zhang  Wengzhong  Li  Jianlin  Li  Yanbin  Xiao  Ming  Peng  Yu  Li  Li  Luan
作者单位:Department of Orthopaedics, The ThirdAffiliated Hospital of Kunming MedicalCollege, Tumor Hospital of YunnanProvince, Kunming, Yunnan 650118,China.
基金项目:This work was supported by the Scientific Reseach Found from Department of Educaton of Yunnan Province (No. 5Y0432C).
摘    要:OBJECTIVE To explore the clinical effect in patients with metastatic spinal tumors treated by percutaneous vertebroplasty (PVP) under the guidance of digital subtraction angiography (DSA). METHODS A total of 110 cases with a metastatic spinal tumor were di- vided into 55 cases in the treatment group (group A ) and 55 cases in the control group (group B ). The general clinical data were statistically analyzed before treatment with the parameters showing no differences. Group A was treated by PVP and chemotherapy as well. Group B was treated by the regular chemotherapy and regular radiation therapy. The same chemotherapy program was used for the same type of disease. All cases were provided with a follow-up survey for 12 months. During the follow-up survey, changes in the quality of life, in evaluation of bone pain and in vertebral column stability as well as adverse reactions were observed. RESULTS The statistics showed a significant difference between the 2 groups, specifically changes in the quality of life and evaluation of bone pain (P〈0.05, t1=2.74, t2=9.02). During the follow-up survey, 5 cases in group A died of other organ complilcations, the death rate being 9.1% (5 out of 55), but all survived more than 3 months following PVP. The vertebral columns of the survivors were kept stable, with no pathological fractures occurring in the vertebral bodies filled with bone cement, there were no obvious adverse reactions, and no paraplegia occurred. Thirteen cases died in group B with a death rate of 23.6% (13 out of 55). Pathological compression fractures in the vertebral bodies occurred in 30 cases, and 12 cases of complicated paraplegia were noted. The incident rate of paraplegia was 21.8% (12 out of 55). CONCLUSION PVP is a simple operation causing only small wounds and few complications. It can effectively alleviate pain of metastatic spinal tumors in patients, improve quality of life and reduce the incidence rate of paraplegia.

关 键 词:脊椎肿瘤  病理机制  治疗  临床表现
收稿时间:2005-09-02
修稿时间:2005-11-11

Clnical study of the treatment of patients with a metastatic spinal tumor by percutaneous vertebroplasty under the guidance of DSA
Zuozhang Yang Jianbo Xu Congguo Jin Pengiie Liu Tao Yuan Baosheng Qian Jinyu Zhang Wengzhong Li Jianlin Li Yanbin Xiao Ming Peng Yu Li Li Luan.Clnical Study of the Treatment of Patients with a Metastatic Spinal Tumor by Percutaneous Vertebroplasty under the Guidance of DSA[J].Chinese Journal of Clinical Oncology,2005,2(6):870-875.
Authors:Zuozhang Yang  Jianbo Xu  Congguo Jin  Pengiie Liu  Tao Yuan  Baosheng Qian  Jinyu Zhang  Wengzhong Li  Jianlin Li  Yanbin Xiao  Ming Peng  Yu Li  Li Luan
Institution:Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical College, Tumor Hospital of Yunnan Province, Kunming, Yunnan 650118,China
Abstract:OBJECTIVE To explore the clinical effect in patients with metastatic spinal tumors treated by percutaneous vertebroplasty (PVP) under the guidance of digital subtraction angiography (DSA).METHODS A total of 110 cases with a metastatic spinal tumor were divided into 55 cases in the treatment group (group A ) and 55 cases in the control group (group B ). The general clinical data were statistically analyzed before treatment with the parameters showing no differences.Group A was treated by PVP and chemotherapy as well. Group B was treated by the regular chemotherapy and regular radiation therapy. The same chemotherapy program was used for the same type of disease. All cases were provided with a follow-up survey for 12 months. During the follow-up survey, changes in the quality of life, in evaluation of bone pain and in vertebral column stability as well as adverse reactions were observed.RESULTS The statistics showed a significant difference between the 2 groups, specifically changes in the quality of life and evaluation of bone pain (P<0.05, t1=2.74, t2=9.02). During the follow-up survey, 5 cases in group A died of other organ complilcations, the death rate being 9.1% (5out of 55), but all survived more than 3 months following PVP. The vertebrai columns of the survivors were kept stable, with no pathological fractures occurring in the vertebral bodies filled with bone cement, there were no obvious adverse reactions, and no paraplegia occurred. Thirteen cases died in group B with a death rate of 23.6% (13 out of 55). Pathological compression fractures in the vertebral bodies occurred in 30 cases, and 12 cases of complicated paraplegia were noted. The incident rate of paraplegia was 21.8% (12 out of 55).CONCLUSION PVP is a simple operation causing only small wounds and few complications. It can effectively alleviate pain of metastatic spinal tumors in patients, improve quality of life and reduce the incidence rate of paraplegia.
Keywords:percutaneous vertebroplasty  spine  metastatic tumor  inter vention  bone cement
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