多层螺旋CT引导经皮椎体成形术治疗椎体转移瘤

Percutaneous vertebroplasty under CT guidance in the treatment of vertebral metastases

目的探讨经皮椎体成形术(PVP)在治疗椎体转移瘤的疗效和安全性。方法对70例椎体转移瘤的82个椎体行PVP治疗,PVP在CT引导下进行,经一侧椎弓根或椎体侧旁入路,单节椎体骨水泥的用量为2～6ml。结果均一次穿刺成功,技术成功率为100%。术后7d内疼痛缓解CR43例,PR20例,MR7例,镇痛有效率为90%(63/70)。12例骨水泥向椎体周边组织渗漏,包括引流静脉3例,椎旁软组织3例,椎间盘5例,椎管1例,除1例椎管内少量骨水泥溢入引起一过性下肢麻木外,其余均未出现明显临床症状。结论多层螺旋CT引导下椎体成形术安全、有效,值得推广应用。

Objective To evaluate the therapeutic effect and safety of percutaneous vertebroplasty（PVP） in the treatment of vertebral metastases. Methods PVP was performed in 70 patients with 82 vertebral metastases. Under CT guidance,2～6ml PMMA was injected per vertebra. Results The technical success rate was 100%. After 7-day observation,the pain in 63 cases was alleviative,including CR in 43 cases,PR in 20 cases. The total effective rate（CR＋PR） was 90.0%. PMMA leakage was occurred in 12 cases,all of which have no obvious clinical complications except vertebral canal leakage in 1 case. Conclusion： PVP is a safe and effective technique which should be widely applied.