经皮椎体后凸成形术对胸腰椎溶骨性肿瘤的疗效观察

目的：观察经皮椎体球囊后凸成形术（PKP）治疗胸腰椎溶骨性肿瘤的疗效及安全性。方法：回顾性分析2009年1月至2010年10月经皮椎体成形术（PVP）治疗胸腰椎溶骨性肿瘤35例，其中脊柱转移瘤23例，血管瘤9例，多发性骨髓瘤3例。术前均有顽固性背痛，无神经症状，CT及MRI提示椎体溶骨性病变。在C型臂透视下行椎弓根穿刺球囊扩张椎体后注射骨水泥，采用VAS评分、WHO疼痛缓解标准及Owestry功能障碍指数（ODD来评估疼痛缓解，日常功能恢复情况，并对病椎的高度变化进行分析，记录骨水泥外漏情况。随访时间为术后1天、1月、6月，采用t检验进行统计学分析。结果：35例患者手术顺利，术后24h内疼痛缓解，无脊髓或神经根损伤及压迫症状，复查X片见椎体内骨水泥填充良好。手术前后VAS评分、活动能力（ODD和病椎高度对应比较，差别均有统计学意义（P〈0．05），术后随访6月疼痛缓解、日常活动功能改善趋于稳定。结论：PKP能迅速缓解胸腰椎溶骨性肿瘤引起的疼痛，有效恢复病椎高度，并发症相对较少，提高患者生存质量，具有简单、安全、有效等优点。

Evaluation of percutaneous kyphoplasty for treating osteolytic tumor of thoracic lumbar vertebrae

Objective：To evaluate safety and effectiveness by percutaneous kyphoplasty （PKP）in patients with osteolytic tumor of thoracic lumbar vertebrae, nethods：A retrospective study was conducted to review 35 cases by PKP of osteolytic tumor of vertebrae from January 2009 to December 2010 in Xi＇an red cross hospital, As the research object, metastatic spinal tumor 23 cases,hemangioma 9 cases and multiple myeloma 3 cases. All the patients had a refractoriness back pain,without symptom of nervous lesion. CT and MRI showed osteolytic changes in the vertebrae. The operation involved percutaneously inserting inflatable the vertebral body and creating a cavity filled with bone cement. The visual analogue scales （VAS）, WHO stan- dards for pain relief and owestry disability index （ODD were recorded completely the procedures, analyzed the change of height in abnormal vertebrae and recorded conditions in postoperative leakage of PMMA. These data were followed up in 1 day, 1 month and 6 months and analyzed using T test. Results：The total 35 operations were done successfully. All patients got a conspicuous pain relief in 24 hours after operation, and nospinal injury or compression was found. The X-ray showed that the treated vertebrae were filled well by cement. There were significant differences of pain levels, locomotor activity scales （ODI） and the height of vertebral bodies before and after operation （P〈0.05）. At 6 months follow up showed that clinic therapeutic were been stabled in odynolysis and locomotor activity scales. Conelusion：PKP is a single safe and effective way to treat osteolytic tumor of thoracic lumbar vertebrae, it can quickly ease the pain caused by osteolytic spinal tumor, recover height the abnormal vertebral, less complication and improve patients life quality.