脊椎原发性骨肿瘤的介入治疗

目的研究脊椎原发性骨肿瘤术前化疗及选择性动脉栓塞的安全性、疗效评价标准及临床价值。方法对术前采用化疗及选择性动脉栓塞且术后经病理证实的16例资料完整的椎体肿瘤进行回顾性分析。采用Seldinger技术,将导管超选择性地插入所需栓塞的肿瘤供血动脉,进行化疗,再以明胶海绵颗粒为栓塞材料进行选择性动脉栓塞。结果化疗、栓塞后肿瘤供血动脉大部分阻断,肿瘤染色较栓塞前减少>75%,术中出血量为500～2000ml,平均为810ml,手术切除顺利;术后标本病检肿瘤细胞坏死率为91%～95%;疼痛症状缓解率为95%。本组均未发生严重并发症。结论脊椎肿瘤术前行化疗及选择性动脉栓塞,是一种操作简便,安全可靠的有效方法。

Interventional Treatment of Spinal Primary Bone Tumor

Objective To study the safety,result-evaluating standards and clinical value of pre-operative chemotherapy and selective arterial embolism(SAE)for spinal primary bone tumor.Methods 16 cases of post-operative-pathology-proved spinal tumor that received chemotherapy and SAE before surgery and had complete data were retrospectively analyzed;using Seldinger technique,the catheter was ultra-selectively inserted into the supplying artery of tumors,then the chemotherapy and SAE using gelfoam granulae as the embolic material were performed.Results Most of the supplying arteries of the tumors were blockaded after chemotherapy and SAE;the tumor staining was decreased by > 75% compared with the pre-embolism;the intra-operative bleeding ranged 500 to 2000 ml and averaged 810 ml;the surgical removal was successful;the tumor cell necrotic rate was 91% to 95% through post-operative sample pathological examination;and the painful remission rate was 95% to 100%.No severe complications occurred in this series.Conclusion The pre-operative chemotherapy and SAE for spinal tumor are effective,simple,safe and reliable methods