经皮椎体成形术在治疗椎体转移瘤中疼痛效果的临床意义

目的：探讨经皮椎体成形术（PVP）结合病灶组织活检在脊柱椎体转移瘤治疗中的应用。方法2012年9月至2013年9月，对25例脊柱椎体转移性肿瘤患者进行PVP，且术中取病灶组织活检。结果25例患者均获随访3-6个月，平均4个月。随访时疼痛评价采用视觉模拟评分法（VAS）进行疼痛评分。18例完全缓解（VAS平均2分），6例部分缓解（VAS平均4分），1例轻度缓解（VAS平均6分）。未出现骨水泥渗漏。术后所有患者根据病灶组织活检报告，均进行了放化疗，效果满意。结论 PVP具有缓解疼痛，预防椎体进一步骨折、塌陷及截瘫，且患者可早期下地，明显提高了患者生活质量，是治疗脊柱转移瘤剧烈疼痛的有效方法。且术中取病灶组织活检，明确转移瘤细胞性质，为进一步放化疗奠定基础。

Objective To evaluate the value of percutaneous vertebroplasty （PVP） combined with biopsy for the treatment of vertebral metastasis. Methods PVP combined with biopsy was applied in 23 cases of vertebral metastasis from Sept, 2012 to Sept, 2013. The clinical data were collected and analyzed. Results All the 25 patients were followed up for 3-6 months, with average of 4 months, Severity of back pain was evaluated by using visual analog scale （VAS）. 18 patients reported complete pain relief （mean VAS was 2）, 6 partial relief（ mean VAS was 4）, 1 slightly relief（mean VAS was 6）, There was no vertebral bone cement extravasation. All the patients underwent the chemocherapy according the pathology reports of biopsy and the effects were satisfactory. Conclusions PVP can relieve the pain and prevent the fracture and related paralysis due to vertebral metastases. Early mobilization can be achieved for such patients, which promotes their life qualities, thus making PVP an effective treatment. Intraoperative biopsy can provide pathology evidence for chemotherapy.