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Hongyi Cai Xiaohu Wang Huiping Cao Xiaoqi Wang Xiaodong Liu Zhiyong Zhang Xinchun Dong 《中国肿瘤临床(英文版)》2005,2(4):737-743
OBJECTIVE Vertebral metastases are a common manifestation in patients with advanced cancer and treatment is often ineffective. This study was conducted to explore the efficacy of treating vertebral metastases by percutaneous vertebroplasty (PVP) combined with interventional chemotherapy. METHODS Seventy-five patients with vertebral metastases (42 men, 33 women; ages 31-76 years) were divided into 2 groups: 39 cases were treated by PVP combined with chemotherapy (VPCC group), and 36 cases were treated by PVP alone (VP group). All procedures were guided by computed tomography (CT) scanning. The results and complications were evaluated by a questionnaire regarding pain and routine follow-up. RESULTS The response rate was significantly higher in the VPCC group than in the VP group (93.0% vs 74.4%, P〈0.05); total response rates for the VPCC and VP groups were 25.6% and 10.3% respectively. A common complication related to VPCC was transient aggravating pain. CONCLUSION PVP may ameliorate pain, and consolidate the vertebrae of patients with vertebral metastases. Its short-term effect may be enhanced by adding drugs into the bone cement. 相似文献
53.
Bong Gun Lee Jung-Hwan Choi Dong-Yun Kim Won Rak Choi Seung Gun Lee Chang-Nam Kang 《The spine journal》2019,19(2):301-305
Background context
It has been reported that newly developed osteoporotic vertebral compression fractures (OVCFs) occur at a relatively high frequency after treatment. While there are many reports on possible risk factors, these have not yet been clearly established.Purpose
The purpose of this study was to investigate the risk factors for newly developed OVCFs after treatment by vertebroplasty (VP), kyphoplasty (KP), or conservative treatment.Study design/setting
A retrospective comparative study.Patient sample
One hundred thirty-two patients who had radiographic follow-up data for one year or longer among 356 patients who were diagnosed with OVCF and underwent VP, KP or conservative treatment between March 2007 and February 2016.Outcome measures
All records were examined for age, sex, body mass index (BMI), rheumatoid arthritis and other medical comorbidities, osteoporosis medication, bone mineral density (BMD), history of vertebral and nonvertebral fractures, treatment methods used, level of fractures, and presence of multiple fracture sites.Methods
Patients were divided into those who manifested new OVCF (Group A) and those who did not (Group B). For the risk factor analysis, student's t-tests and chi-square tests were used in univariate analysis. Multivariate logistic regression analysis was carried out on variables with a p<.1 in the univariate analysis.Results
Newly developed OVCFs occurred in 46 of the 132 patients (34.8%). Newly developed OVCF increased significantly with factors such as average age (p=.047), low BMD T-score of the lumbar spine (p=.04) and of the femoral neck (p=.046), advanced age (>70 years) (p=.011), treatment by cement augmentation (p=.047) and low compliance with osteoporosis medication (p=.029). In multivariate regression analysis, BMD T-score of the lumbar spine (p=.009) and treatment by cement augmentation (p=.044) showed significant correlations with the occurrence of new OVCFs with a predictability of 71.4%.Conclusion
Osteoporotic vertebral compression fracture patients with low BMD T-score of the lumbar spine and those who have been treated by cement augmentation have an increased risk of new OVCFs after treatment and, therefore, require especially careful observation and attention. 相似文献54.
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支架结合弹簧圈治疗破裂椎动脉夹层动脉瘤 总被引:2,自引:0,他引:2
目的评估支架结合弹簧圈技术治疗破裂椎动脉夹层动脉瘤(VADA)的可行性、有效性和安全性。方法回顾性分析57例破裂VADA的临床资料,均使用支架结合弹簧圈技术治疗,按使用支架数量分为单支架组(n=32)和多支架组(n=25),比较两组间即刻和随访的影像学结果及临床结果。结果治疗即刻VADA完全栓塞、近全栓塞和部分栓塞,单支架组分别为4例(12.5%)、7例(21.9%)、21例(65.6%),多支架组分别为13例(52%)、7例(28%)、5例(20%)。影像学随访12~78个月,单支架组30例,其中VADA完全栓塞19例(63.3%),显影11例;多支架组24例,其中VADA完全栓塞23例(95.8%)、显影1例。术后即刻与随访期VADA完全栓塞率,多支架组显著高于单支架组(P〈0.05)。死亡3例。改良mRS评分在两组间差异无统计学意义(P〉0.05)。结论长期随访结果显示,支架辅助栓塞治疗破裂椎动脉夹层动脉瘤在技术上是安全有效的,多支架结合弹簧圈栓塞可有效提高即刻及远期的完全栓塞率,降低术后复发及再出血风险。 相似文献
57.
Sarina K. Sinclair Spencer Bell Richard Tyler Epperson Roy D. Bloebaum 《Anatomical record (Hoboken, N.J. : 2007)》2013,296(5):736-744
To gain an understanding of the vertebral cortical endplate and factors that may affect the ability to achieve skeletal attachment to intervertebral implants and fusion, this study aimed to characterize the hypermineralized tissue on the cortical endplate of the vertebral body on a commonly used animal model. Skeletally mature sheep were injected with tetracycline prior to euthanasia and the C2‐C3, T5‐T6, and L2‐L3 spinal motion segments were excised and prepared. Vertebral tissues were imaged using backscatter electron (BSE) imaging, histology, and tetracycline labeling was used to assess bone remodeling within different tissue layers. It was determined that the hypermineralized tissue layer was calcified fibrocartilage (CFC). No tetracycline labels were identified in the CFC layer, in contrast to single and double labels that were present in the underlying bone, indicating the CFC present on the cortical endplate was not being actively remodeled. The average thickness of the CFC layer was 146.3 ± 70.53 µm in the cervical region, 98.2 ± 40.29 µm in the thoracic region, and 150.89 ± 69.25 µm in the lumbar region. This difference in thickness may be attributed to the regional biomechanical properties of the spine. Results from this investigation indicate the presence of a nonremodeling tissue on the cortical endplate of the vertebral body in sheep spines, which attaches the intervertebral disc to the vertebrae. This tissue, if not removed, would likely prevent successful bony attachment to an intervertebral device in spinal fusion studies and total disc replacement surgeries. Anat Rec, 296:736–744, 2013. © 2013 Wiley Periodicals, Inc. 相似文献
58.
ABSTRACTSpinal epidural abscess may complicate vertebral osteomyelitis. The purpose of this report is to discuss its course in two patients with sensory/motor and cognitive impairment and to demonstrate the need for its early detection. Delayed detection may lead to spinal cord injury or meningitis. It may also delay functional return and hinder intensive rehabilitation efforts. Two patients are presented. 相似文献
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目的:探讨彩超对锁骨下动脉综合征(SSS)的检查技巧及临床诊断价值。方法选取我院2010年8月-2013年6月间确诊为锁骨下动脉盗血综合征患者53例,进行颈动脉、椎动脉及锁骨下动脉二维超声及彩色多普勒超声检查,分析血流动力学特点。结果53例患者中动脉粥样硬化38例,多发性大动脉炎15例。根据椎动脉频谱特点划分为隐匿型SSS共17例,患侧椎动脉频谱收缩期出现切迹;部分型SSS共26例,患侧椎动脉收缩期血流反向;完全型SSS共10例,患侧椎动脉血流收缩及舒张期均反向。结论彩超对于早期筛查SSS具有明显优势,并可对大多数SSS进行病因学诊断。 相似文献