经皮椎体成形术治疗颈椎转移瘤的初步研究

The preliminary report on percutaneous vertebroplasty for cervical vertebral metastases

目的 应用椎体成形术 (PVP)治疗颈椎转移瘤 ,观察其疗效 ,探讨椎体成形术治疗颈椎病变的操作技术。方法 对 11例颈椎单椎体转移瘤病变椎体行PVP治疗 ,均应用国产器械与骨水泥(聚甲基丙烯酸甲酯 ,PMMA) ,其中C2 1例 ,C32例 ,C4 4例 ,C5 3例 ,C6 1例。在X线透视监测下经前外侧入路途径操作 10例 ,在CT和X线透视联合监测下经后外侧入路途径行C2椎体成形术 1例。PMMA在牙膏期向椎体内注射。于手术前后行CT检查对照。对患者随访 7～ 12个月 ,观察临床疗效。结果 11例穿刺全部成功 ,术后CT检查显示PMMA填充病灶均在 5 0 %以上。术后 7d内 11例患者均有不同程度的疼痛缓解 :疼痛完全缓解 (CR) 6例 ,部分缓解 (PR) 5例。止痛效果在 6个月内为7(7/ 10 )例 ,在 1年内为 5 (5 / 9)例。未发生由于穿刺途径出血或PMMA外溢出现临床症状的并发症。结论 椎体成形术治疗颈椎转移瘤效果良好。

Objective To evaluate the treating effect of percutaneous vertebroplasty (PVP) for cervical vertebral metastasis, and to explore the cervical vertebral technique of percutaneous vertebroplasty.Methods Eleven cases with single cervical vertebral metastasis underwent PVP, including C2 in 1case, C3 in 2 cases, C4 in 4 cases, C5 in 3 cases, and C6 in 1 case.PVP was performed with the instruments and PMMA made in China.Anterolateral route was used under the guidance of fluoroscopy in 10 cases, and posterolateral route was used under the guidance of CT combined with fluoroscopy in 1 case of C 2 vertebra.PMMA was injected in the paste period.CT scans were performed before and after the procedures.Results The successful puncturing of PVP was obtained in 100%.The percentage of lesion PMMA filling was more than 50 % demonstrated by CT.The clinical data of 11 cases was followed up for 7 to 12 months.The rate of marked or complete pain relief was demonstrated in all cases (CR in 6 cases, PR in 5 cases) within 7 days, 7/10 in 6 months, and 5/9 in 12 months, respectively, after operation.There was no bleeding of the puncturing route or leakage of PMMA related complications with clinical performance.Conclusion The clinical effect of percutaneous vertebroplasty for cervical vertebral metastasis was satisfied.