经皮穿刺骨水泥灌注椎体成形术对胸腰椎肿瘤疼痛的治疗

目的评价经皮穿刺骨水泥聚甲基丙烯酸甲酯（PMMA）灌注椎体成形术治疗胸腰椎肿瘤疼痛的疗效。方法对35例胸腰椎肿瘤患者的54个椎体施行经皮穿刺骨水泥灌注椎体成形术,术后1周及3、6、12个月进行常规随访,采用视觉模拟评分法（VAS）对治疗前后患者疼痛状况进行评估和分级。结果24例获得明显的疼痛症状缓解,4例获得轻度缓解,7例无改善。2例术后出现神经症状加重。9个椎体出现骨水泥渗漏,其中2例术后出现神经根损伤。平均随访（12.0±3.4）个月。术后1周优良率为68.6%,有效率为80.0%。结论经皮穿刺骨水泥灌注椎体成形术具有创伤小、操作简单、并发症少的特点。能够有效缓解脊柱转移瘤患者疼痛,有效预防椎体病理性骨折的发生,改善患者生活质量。

The treatment of thoracolumbar tumorous pain by percutaneous vertebroplasty

Objective To evaluate the clinical effect of treating thoracolumbar tumorous pain by percutaneous vertebroplasty（PVP）.Methods 35 patients of thoracolumbar metastatic tumors involved 54 vertebral bodies were treated with percutaneous injections of cement polymethylmethacrylate（PMMA） via pedicle of vertebra under X-ray guidance.All of the patients were examined at one week,and three,six and twelve months after operation,the degree of pain was evaluated and classified by visual pain scale and the prolo score（VAS）.Results Of 35 patients,the pain was released clearly in 24 cases,released slightly in 4 cases,and no change in 7 cases.But neurological symptom was aggravated in 2 cases after operation.Nine vertebraes had the leakage of cement,including 2 cases with nerve root injury.The followed-up time was（12.0±3.4）months.The rate of excellent and good results was 68.6% after one year,and the effective rate was 80.0%.Conclusions Percutaneous vertebroplasty（PVP） is a simple and minimally invasive treatment with few complications,which can release pain,decrease incidence of pathologic constrictive fracture in spinal body,and improve lift quality of patients with thoracolumbar tumors.