CT引导经皮置钉治疗病理性骶髂关节疼痛

背景大多数后路骨盆和骶髂关节转移肿瘤患者为临终患者,其治疗目的主要是姑息治疗和减轻疼痛,提高患者生活质量.目的探讨在CT引导下经皮微创技术置入空心拉力螺钉治疗病理性骶髂关节疼痛.设计前后对照的临床试验.地点和对象在浙江省宁波市第六医院完成.8例骶髂关节转移肿瘤患者,男4例,女4例;年龄12～83岁.方法对8例骶髂关节转移肿瘤患者试行在CT引导下经皮微创技术置入空心拉力螺钉稳定病理性骶髂关节不稳.术前和术后进行Enneking疼痛评分.主要观察指标手术前后疼痛恢复情况.结果经2年5个月随访,患者疼痛减轻,平均3.2分,范围0～5分.结论CT引导下经皮置入空心拉力螺钉能有效缓解病理性骶髂关节不稳所致的疼痛.

Percutaneous CT-guidedfixation of sacroiliac joint with cannulated lag screw for treating pathologic pain ofsacroiliac joint

BACKGROUND: Most patients with posterior pelvic and sacroiliac metastasis are terminally ill. Their treatment is usually palliative and directed toward relieving pain and improving the quality of life with the least possible intervention.OBJECTIVE: To investigate the possibility of percutaneous CT-guided fixation of sacroiliac joint with cannulated lag screw treatment for pathologic pain of sacroiliac joint.DESIGN: Preoperative and postoperative auto-control clinical trial was conducted.SETTING and PARTICIPANTS: The study was completed in Ningbo Sixth Hospital. Eight patients(4 males and 4 females, aged 12 years to 83 years)with metastatic tumor of sacroiliac joint were selected for our study.METHODS: After treatment with percutaneous CT-guided fixation of sacroiliac joint with cannulated lag screw, the sacroiliac joint of the 8 patients became pathologically unstable. Enneking pain scale was obtained preoperatively and postoperatively.MAIN OUTCOME MEASURES: Pain recovery was assessed preoperatively and postoperatively.RESULTS: After 2. 5 years' follow-up, pain of the patients was relieved with a range of 0 to 5(mean 3.2).CONCLUSION: Percutaneous cannulated lag screws with CT guidance help alleviate the patients' pain due to pathologically unstable sacroiliac joint.