经皮椎体成形术治疗脊柱肿瘤及椎体转移瘤的疗效观察

Curative effect observation of percutaneous vetebral plasty in the treatment of spinal tumor and spinal metastatic tumor

目的观察经皮椎体成形术（PVP）治疗脊柱肿瘤、椎体转移瘤的疗效。方法对29例胸腰椎转移瘤及多发性骨髓瘤患者的86个病椎行PVP术治疗。分别于术后3d及3、6个月采用主诉疼痛分级法（VRS）进行疼痛程度评估。术后6个月采用日常生活自理能力（ADL）量表对患者生活质量进行评估。结果本研究椎体穿刺均成功。术中发生骨水泥沿椎体静脉丛渗漏2例，术中注射骨水泥时发生血压下降2例，下肢轻度刺激性疼痛1例。术中未出现肺栓塞、肋骨骨折等并发症。术后3d及3、6个月疼痛缓解有效率分别为69％、74％、78％。无原椎体再发塌陷。术后出现神经症状2例。术后6个月ADL评分较术前明显改善（P〈0．01）。结论PVP治疗脊柱肿瘤、椎体转移瘤止痛效果好，是一种切实可行的新技术，值得推广应用。

Objective To observe the effect ol percutaneous vertebral pmsty （PVP）on spinal tumor and spinal metastatic tumor. Methods Twenty-nine cases of thoracolumbar metastatic tumor and （or） multiple myeloma, with a total of 86 disease were treated by PVP surgical. The pain degree was es- timated by pain classification method （VRS） on the 3th day, 3 and 6 months postoperation, and the quality of life was estimated by the self-care ability of daily life （ADL） 6 months postoperation. Results The vertebral puncture were successful. Intraoperative, bone cement along the vertebral venous plexus leakage in 2 cases, injection of bone cement occurs when blood pressure drops in 2 cases, lower limb mild irritation pain in 1 case. There was no intraoperative complications such as pulmonary embolism, fractured ribs during operation. The effective pain relief rate of 3th day and 3, 6 months was 69% , 74% , 78%. No original vertebral body collapsed again. And postoperatively, there was 2 cases of neurologic symptoms. Af- ter 6 months, the ADL scores were improved significantly （P 〈0. 01 ）. Conclusions Pereutaneous verte- bral plasty in the treatment of spinal tumor and metastatic tumor, has a good pain relieving effect, and it＇ s a kind of practical new technology, which is worthy of popularization and application.