经皮椎体成形术治疗脊椎转移性肿瘤

目的探讨经皮椎体成形术(PVP)在脊椎骨转移瘤中的治疗效果。方法应用PVP治疗脊柱转移性肿瘤40例共46个椎体。在X线电视监视下或CT引导下经皮穿刺至病变椎体后注入适量骨水泥(聚甲基丙烯酸甲酯,PMMA),观察术后止痛效果、脊椎稳定性情况及并发症情况。结果40例穿刺全部成功,术后1~3d,患者的疼痛均有不同程度缓解疼痛完全缓解(CR)30例33个椎体、疼痛部分缓解(PR)8例10个椎体、轻度缓解(MR)2例3个椎体、疼痛无缓解(NR)0例;病变脊椎稳定性良好,术后影像学检查显示24例26个病椎的肿瘤区域被PMMA完全均匀充填加固,另16例20个椎体大部分充填。术中及术后均无严重并发症,随访1~3月效果良好。结论PVP可作为脊椎骨转移瘤缓解疼痛的方法之一,并可加强病变椎体的稳定性。

Percutaneous Vertebroplasty in Treatment of Vertebral Metastases

Objective To investigate the clinical efficacy of percutaneous vertebroplasty (PVP)for vertebral metastases.Methods 40 cases with 46 vertebral body metastases underwent PVP under the guidance of fluoroscopy or CT.The analgesic effect,vertebral body stability and complications after operation were observed.Results The successful rate of puncture was 100%.The pain relief was demonstrated in all cases(complete relief in 30 cases,partial relief in 8 cases,mld relief in 2 cases) after operation 1 to 3 days.All involved vertebral bodies had good stability.Imaging analysis demonstrated that the metastatic area was completely well-distributed filling and reinforce by polymethymethacrylate(PMMA) in 26 vertebra of 24 cases.The other 20 vertebral of 16 cases were great part filled by PMMA.There were no severe complications both during operation and post-operation.The treating effect was satisfying in the following 1 to 3 months.Conclusion PVP is one of the efficacious way to alleviate pain of vertebral metastases,and it can reinforce the stAbility of involved vertebral body.