影像导航引导椎体成形术治疗多发性椎体转移瘤的临床分析

Using computer-assisted fluoroscopic navigation to guide the percutaneous vertebroplasty to treat multiple spinal metastasis

目的探讨影像导航引导椎体成形术在多发性椎体转移瘤中的临床应用。方法获取23例多发性椎体转移瘤患者，手术椎节的正侧位及斜位片，采用影像导航的方法虚拟成椎体的正侧位及椎弓根轴位片，引导经皮椎弓根穿刺行椎体成形术。结果本组23例患者均为单侧穿刺，导航引导椎体成形术均获成功，术中进行导航虚拟影像与实际穿刺针影像进行匹配，两者影像基本吻合。PMMA的注射量为2～5ml，术后CT复查显示PMMA填充病灶良好。术后完全缓解8例，部分缓解15例。结论影像导航通过术中获取病椎的正侧位及左右的斜位片，模拟手术椎体的正侧位及椎弓根轴位的虚拟影像，可以更加精确地引导椎体成形术治疗多发性椎体转移瘤，减少了手术时间和术中放射线的照射，使手术更安全、更准确、更微创。

Objective To explore clinlic outcomes of using computer-assisted fluoroscopic navigation to guide the percutaneous vertebroplasty to treat multiple spinal metastasis. Methods We get anterio posterior of twenty-three multiple spinal metastasis patients with 59 painful vertebral body were imitated using computer-assisted fluoroscopic navigation to guide the percutaneous vertebroplasty. Results All percutaneous vertebroplasties were one-sided punctured, successful by guiding with computer-assisted fluoroscopic navigation. Navigation virtual puncture needle image match with reality view 8. Postioperational CT showed that the PM- MA filled spinal metastasis focus very well. Complete pain relief was achieved in 8 cases and partial relief in 15 cases. Conclusions Using computer-assisted fluoroscopic navigation to guide the PVP to treat multiple spinal metastasis might decreased operative time and radiation injury. It is a safe, precise, and minimally invasive method.