活检术在经皮椎体后凸成形术中的应用

Application of biopsy during percutaneous kyphoplasty

[目的]评估活检术在经皮椎体后凸成形术(PKP)中应用的价值。[方法]回顾性分析2009年1月～2011年1月收治的108例接受PKP手术的患者,全部患者均行术中活检术。根据术前诊断将患者分为肿瘤组(A组,18例)、诊断不确定组(B组,25例)和骨质疏松组(C组,65例)共3组。记录并比较不同组之间的活检结果情况。[结果]取材活检成功率100%,无活检相关并发症。A组中16例确诊为转移癌,2例为骨质疏松;B组中19例为骨质疏松,5例为肿瘤,1例诊断不明;C组中63例为骨质疏松,2例诊断不明。[结论]经皮椎体后凸成形术中活检有利于明确病因诊断,尤其对于术前怀疑其病因不是骨质疏松的椎体压缩骨折患者。

[ Objective ] To discuss the clinical value of biopsy during percutaneous kyphoplasty. [ Method] A retrospective survey was performed in 108 patients treated by kyphoplasty from January 2009 to January 2011 ,and biopsy was performed during kyphoplasty routinely for all the patients. According to preoperative diagnosis, all the patients were classified into three groups ： tumor group （ group A, n = 18 ）, uncertain group （ group B, n = 25 ） and osteoporosis group （ group C, n = 65 ）. The results of histologic evaluation were recorded. [ Result] The biopsy were completed in all patients with a success rate of 100% without any complication. In group A, 16 showed evidence of spinal tumor,2 had osteoporosis. In group B ,5 showed evidence of spinal tumor, 19 had osteoporosis, and in one the dingnosis was uncertain. In group C, no one showed evidence of spinal tumor, and two was not identified. [ Conclusion ] Biopsy during percutaneous kyphoplasty is useful for final histologic identification, especially for the patients in whom osteoporosis was not suspected before operation.