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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。
Objective To investigate the therapeutic effect of percutaneous vertebroplasty (PVP) in spinal metastases. Methods Forty-six vertebral bodies of 40 patients with metastatic spine were treated with PVP. Under the supervision of X-ray television or CT-guided percutaneous vertebroplasty into the right amount of bone cement (PMMA, PMMA), to observe the postoperative analgesic effect, spinal stability and complications. Results All the punctures were successful in 40 cases. Pain was relieved in 30% of patients with 33 cases of complete remission (CR) and 10 cases of mild pain relief (PR) in 8 cases. (MR) 2 cases of 3 vertebrae, no pain relief (NR) 0 cases; lesions of the spine good stability, postoperative imaging examination showed that 24 cases of 26 cases of vertebral tumor area was uniformly filled with PMMA reinforcement, the other 16 cases Most of the 20 vertebral body filling. There were no serious complications during and after operation. The follow-up of 1 ~ 3 months was effective. Conclusion PVP can be used as one of the methods to relieve pain in spinal metastases, and can enhance the stability of vertebral body.