网袋椎体成形术与传统PVP手术治疗胸腰椎溶骨性转移瘤的疗效对比

Comparison of the effects of mesh bag plasty and traditional PVP operation in the treatment of thoracolumbar vertebral osteolytic metastases

目的探讨网袋椎体成形术与传统PVP手术治疗胸腰椎溶骨性转移瘤的疗效优劣。方法随机选取2013年7月-2017年7月于本院收治的62例(84椎)胸腰椎溶骨性转移瘤患者,依据手术方案的不同分为观察组与对照组各31例。其中,观察组予以网袋椎体成形术治疗,对照组行PVP手术治疗。对两组患者手术前后的相关疗效指标进行比较。结果观察组骨水泥渗漏率为3.2%(1/31),对照组为35.48%(11/31),观察组显著低于对照组(P<0.05);与术前相比,两组出院和术后6个月的VAS评分、ODI指数均显著降低(P<0.05),但组间差异无统计学意义(P>0.05);与术前相比,两组出院和术后6个月的椎体前缘、中部相对高度均有所矫正,但观察组的矫正效果显著优于对照组(P<0.05)。结论两种椎体成形技术治疗胸腰椎溶骨性转移瘤,均可显著减轻疼痛、改善患者功能障碍,但网袋椎体成形术可有效降低骨水泥渗漏率,并起到良好的椎体矫正作用。

Objective To compare the efficacy of mesh bag vertebroplasty and traditional percutaneous vertebroplasty(PVP)in the treatment of thoracolumbar osteolytic metastases.Methods From July 2013 to July 2017,62 patients(84 vertebrae)with thoracolumbar osteolytic metastases admitted to our hospital were randomly selected,and according to different surgical procedures,the patients were divided into observation group and control group,with 31 cases in each group.The observation group was treated with mesh bag vertebroplasty,while the control group received PVP operation.The clinical effects of two groups were compared.Results All 62 patients successfully completed the operation,the cement leakage rate of the observation group was 3.2%(1/31),that of the control group was 35.48%(11/31),the cement leakage rate of the observation group was significantly lower than the control group(P<0.05).Compared with before operation,the VAS score,ODI index of two groups at discharge and 6 months after surgery were significantly reduced(P<0.05),but there were no significant differences between the two groups(P>0.05).Compared with before operation,the relative height of the anterior and middle vertebral bodies of the two groups were corrected at discharge and 6 months after operation,but the corrective effect of the observation group was significantly better than that of the control group(P<0.05).Conclusion Both two vertebroplasty techniques can relieve pain and improve the function of patients with thoracolumbar osteolytic metastases,and the mesh bag vertebroplasty can effectively reduce the bone cement leakage rate and play a good role in vertebral correction.