CT引导经皮置钉治疗病理性骶髂关节疼痛

CT-guided percutaneous fixation of cannulated lag screw on sacroiliac joint for treatment of pathologic pain of sacroiliac joint

目的:探讨在CT引导下经皮微创技术置入空心拉力螺钉治疗病理性骶髂关节疼痛.方法:骶髂关节转移肿瘤患者8例,男4例,女4例;年龄12～83岁,平均53岁.单侧转移5例,双侧3例.肺癌2例,乳腺癌1例,卵巢癌1例,非霍奇金淋巴瘤1例,横纹肌肉瘤1例,骨髓瘤1例,前列腺癌1例.试行在CT引导下经皮微创技术置入空心拉力螺钉稳定病理性骶髂关节不稳.术前和术后通过Ennek-ing疼痛评分进行比较.结果:8例均获随访,随访时间4个月～29个月,平均18.2个月.均1周内疼痛缓解,无并发症发生,3例术后6个月内死亡,余5例疼痛明显减轻.结论:CT引导下经皮置入空心拉力螺钉能有效缓解病理性骶髂关节不稳所致的疼痛.

Objective： To investigate the possibility of CT-guided percutaneous fixation of cannulated lag screw on sacroiliac joint for treatment of pathologic pain of sacroiliac joint. Methods：Eight patients（4 male, 4 female;the average age of 53 years ranging in age from 12 to 83 years）with metastatic tumor of sacroiliac joint included 3 patients of bilateral involvement and remaining 5 patients of unilateral metastases. Two patients had lung cancer, 1 patient had mammary cancer, 1 patient had ovario-cancer, 1 patient had non-Hodgkin＇s lyrnphoma, 1 patient had rhabdomyosarcoma, 1 patient had myeloma, 1 patient had prostatic carcinoma. All patients were treated by CT-guided percutaneous fixation on sacroiliac joint with eannulated lag screw for treatment of unstable of sacroiliac joint. Enneking Pain Scores of preoperative were as compared with postoperative. Results：All patients had followed-up from 4 to 29 months（mean, 18.2 months）. All patients reported good improvement in pain control in the first postoperative week. There were no complications associated with the surgical procedure. Three patients died within 6 months after operation. The other 5 patients had improved the quality of life and excellent pain control. Conclusion： Percutaneous screw with CT guidance can alleviate pain in patients with metastatic disease involving the sacroiliac region.