经皮椎体成形术及经皮椎体后凸成形术治疗椎体转移瘤的临床应用 |
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引用本文: | 刘启榆,王忠,杨伟,周西,范丹丹,杨勇,罗海燕. 经皮椎体成形术及经皮椎体后凸成形术治疗椎体转移瘤的临床应用[J]. 四川肿瘤防治, 2014, 0(1): 24-28 |
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作者姓名: | 刘启榆 王忠 杨伟 周西 范丹丹 杨勇 罗海燕 |
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作者单位: | 四川省绵阳市中心医院放射介入诊疗中心,四川绵阳621000 |
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摘 要: | 目的:探讨经皮椎体成形术(PercutaneousvertebroplastyPVP)及经皮椎体后凸成形术(KyphoplastypereutaneousPKP)治疗椎体转移性肿瘤的临床疗效。方法:对38例共44个椎体行PVP,7例9个椎体行PKP,术前VAS标准(visualanalogscale,VAS)评分。结果:45例53个椎体手术无死亡病例。术前轻度疼痛4例,中度11例,剧痛31例。术前VAS评分平均为9.2±2.2分。术后3天疼痛完全缓解38例(84.4%);部分缓解5例(11.1%);轻微缓解1例(2.2%);NR1例(2.2%);有效为95.5%,VAS评分2.0±1.4,与术前比较差异有统计学意义(P〈0.05);53个椎体术中骨水泥渗漏至椎间盘3例,硬膜外囊2例,椎旁静脉丛1例,椎旁软组织3例;骨水泥外漏发生率16.98%,其中PKP仅发生椎旁软组织外渗1例,术中及术后均无其它并发症发生。PVP式Cobb’s角术前19.3±8.7,术后为18.4±7.8;PKP术前为22.1±8.7,术后为12.2±5.8,术后Cobb’s角与术前比较,PKP术式差异有统计学意义(P〈0.01),PVP术式差异无统计学意义(P〉0.05);轻度疼痛及中度疼痛完全缓解及部分缓解为100%;重度疼痛完全缓解及部分缓解为93.6%,轻微缓解及无效为6.4%,轻、中、重度各级术后较术前疼痛缓解明显,差异有统计学意义(P〈0.05)。结论:PVP及PKP对缓解或消除由椎体转移性肿瘤引起的疼痛有明显的治疗效果,无严重并发症。PKP术对塌陷椎体高度有一定程度恢复。
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关 键 词: | 椎体成形术 经皮椎体后凸成形术 椎体 转移性肿瘤 |
The Clinical Application of Percutaneous Vertebroplasty or Kyphoplasty Percutaneous Treatment for Vertebral Metastases |
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Affiliation: | Liu Qiyu, Wang Zhong , Yang Wei, ( Mianyang Central Hospital lnterventional Radiology Treatment Center, et al Mianyang 621000, Sichuan, China) |
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Abstract: | Objective: To investigate percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) treat- ment for vertebral metastases. Methods: PVP was performed in 38 patients with 44 vertebrae involvement and PKP was performed in 7 patients with 9 vertebrae involvement. VAS ( visual analog scale, VAS) score was evaluated before opera- tion. Results: No operation-related death occurred in the 45 cases. There were 4 cases with mild pain , 11 moderate pain and 31 severe pain before operation with the average VAS was 9.2 +2.2. Complete remission of pain was got in 38 cases (84.4%) ,partial remission in 5 cases( 11.1% ) ,slight remission in 1 case(2.2% ) and NR in 1 case(2.2% ) 3 days af- ter operation. The effective rate was 95.5% with VAS score was 2.0. -+ 1.4 which was significantly lower that before oper- ation( P 〈 0.05 ). Bone cement leakage occurred in 9 case( 16.98% ), including 3 intervertebral leaks , 2 epidural leaks, 1 paravertebral venous plexus and 3 paravertebral soft tissue soft tissue leaks; only 1 paravertebral soft tissue leaks occured after PKP. Cobb's angle was 19.3 -+ 8.7 preoperation and 18.4 + 7.8 postoperation after PVP without significant differ- ence(P 〉 0.05). It was 22.1 _+ 8.7 preoperation and 12.2 + 5.8 postoperation in PKP with significant difference(P 〈 0.01 ). CR and PR of mild pain and moderate pain was 100% ,93.6% of severe pain. MR and NR was 6.4% for severe pain. Pain at different level was statistically relieved after operation( P 〈 0.05 ). Conclusion: PVP and PKP could providesignificant pain relief in vertebral metastases; PKP could recover collapsed vertebral body in some degrees. |
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Keywords: | Percutaneous Vertebroplasty Percuta- neous Kyphoplasty Vertebral Body Metastatic Tumor |
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