经皮椎体成形术治疗后壁缺失脊柱转移瘤的安全性和有效性

崔云鹏; 潘元星; 米川; 王冰; 林云飞; 施学东

doi:10.3971/j.issn.1000-8578.2019.18.1791

经皮椎体成形术治疗后壁缺失脊柱转移瘤的安全性和有效性

Safety and Efficacy of Percutaneous Vertebroplasty on Spinal Metastases with Incomplete Posterior Wall

摘要

摘要:
目的探讨经皮椎体成形术治疗后壁缺失的脊柱转移瘤患者的安全性和有效性。
方法回顾性分析106例经皮椎体成形术治疗的后壁缺失的脊柱转移瘤患者资料。记录患者人口学特征和术前、术后临床资料，分析手术前后患者疼痛和功能改善情况、全身并发症以及局部骨水泥渗漏情况。
结果 106例患者均安全完成手术，术后VAS评分3.0（2.0~5.0）分，下降了5.0（3.0~7.0）分，70例患者接受巴氏量表评定日常生活能力，其中10例患者术后功能分级较术前改善，46例患者同术前。患者术中均无骨水泥相关全身并发症发生。接受治疗的160节后壁缺失的椎体中39节（24.4%）出现骨水泥渗漏，其中7节（4.4%）为椎管内渗漏，所有患者术后均未出现骨水泥渗漏相关并发症。
结论应用经皮椎体成形术治疗后壁缺失的脊柱转移瘤有良好的临床疗效和安全性。

Abstract:
Objective To evaluate the safety and efficacy of percutaneous vertebroplasty(PVP) in the treatment of spinal metastases with incomplete posterior wall.
Methods We retrospectively analyzed 106 spinal metastases patients with incomplete posterior wall treated with PVP. Demographic and pre- and post-operative clinical characteristics were reviewed. Pain relief and functional activities recovery, systemic complications and the local leakage of the bone cement were evaluated before and after operation.
Results All patients successfully underwent surgery, VAS score was 3.0(2.0-5.0) after operation and decreased for 5.0(3.0-7.0). Among 70 patients who received the assessment, 10 patients had a better Barthel Index(BI) and 46 patients were with the same activity of daily living. None had systemic complications during the injection of bone cement. Among the 160 vertebrae with incomplete vertebral posterior wall, 39(24.4%) vertebrae showed bone cement leakage and 7(4.4%) vertebrae were intraspinal leakage. None had bone cement leakage-related neurological symptoms after operation.
Conclusion Percutaneous vertebroplasty is effective and safe in the treatment of spinal metastases with incomplete posterior wall.

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