CT引导经皮椎体成形术治疗椎体转移瘤

Clinical value of percutaneous vertebroplasty for the treatment of vertebral metastases under CT guidance

目的:回顾性评价CT引导下经皮椎体成形术治疗椎体转移瘤的疗效及其并发症。方法:2008-10～2010-10共治疗椎体转移瘤患者27例,共36个椎体。患者均有顽固性胸背痛,术前VAS评分平均9.1分,伴脊髓压迫者2例,术前Frankel分级C级3例,D级4例,均采用CT引导下经皮椎体穿刺行病变椎体内骨水泥注射治疗。随访观察并发症发生情况及治疗效果。结果:36个椎体在CT引导下均一次穿刺成功,术后疼痛缓解有效率为88.4%,完全缓解率27.9%,VAS评分术后(2.5±1.6)较术前(7.4±1.3)显著下降(P<0.05)。随访7～24个月,中位数10.8个月,末次随访时VAS评分2.98±0.81分,有效率78%,与术前比较差异有显著性(P<0.01);骨水泥外溢发生率为25%,无一例发生严重并发症。结论:CT引导下经皮椎体成形术具有良好的止痛及预防病理性骨折作用,改善患者生活质量,是治疗椎体转移性肿瘤安全、有效的方法。

Objective：To retrospectively evaluate the efficacy and safety of percutaneous vertebroplasty（PVP） in the treatment of vertebral tumors under CT guidance.Methods： From October 2008 to October 2010,27 patients with vertebral metastases were treated by PVP under CT guidance.Thirty-six vertebroplasties were performed in 18 males and 9 female patients.Before the operation,all patients had severe back pain with average VAS scores at 9.1,there were 2 cases of spinal cord compression,3 cases of grade C and 4 cases of grade D according to Frankel classification.The clinical effect and complications were observed after the operation.Results：All 36 vertebral bodies was punctured successfully at one time.The efficacious rate and complete remission rate of back pain after PVP were 88.4% and 27.9%,respectively.There was significant difference in VAS score before and after operation（2.5±1.6 vs 7.4±1.3）（P0.01）.The patients were followed up for 7 to 24 months（median 10.8 months）,they all had significant improvement in clinical condition（P0.01）.The main complication was bone cement leakage（25%）,but no serious complication occurred.Conclusion： Percutaneous vertebroplasty is a safe and effective procedure which relieve back pain and improve life quality for the patients with vertebral metastatic tumor.