CT引导下经皮穿刺局部药物注入治疗脊柱嗜酸性肉芽肿12例

CT-guided percutaneous local injection of drugs for the treatment of spinal eosinophilic granuloma:preliminary results in 12 patients

目的探讨CT引导下经皮穿刺脊柱嗜酸性肉芽肿局部注入利多卡因+甲泼尼龙琥珀酸钠治疗的临床疗效和安全性。方法分析2010年3月—2019年3月行CT引导局部药物注入治疗的脊柱嗜酸性肉芽肿患者12例,局部疗效评估采用Neer与Chigira骨囊肿X线愈合评价标准,疼痛程度和日常活功能障碍情况采用视觉模拟评分(VAS)和Oswesty功能障碍指数(ODI)进行评价。结果12例患者共16个病灶,穿刺成功率100%,经治疗后患者局部疼痛均得到有效缓解。术后1、3、6、12个月患者局部病灶治愈率分别为25%、62.5%、87.5%、100%;术后3个月,VAS由术前8分,降为1分;ODI术前平均为56.5%,降至平均8.5%。未见严重并发症和死亡病例。结论CT引导局部注入利多卡因+甲泼尼龙琥珀酸钠治疗脊柱骨嗜酸性肉芽肿安全微创、疗效确切、止疼效果明显,是有效治疗方法。

Objective To evaluate the clinical efficacy and safety of CT-guided percutaneous local injection of lidocaine plus methylprednisolone sodium succinate in treating spinal eosinophilic granuloma(EG). Methods From March 2010 to March 2019, a total of 12 patients with spinal EG received CT-guided percutaneous local injection of lidocaine plus methylprednisolone sodium succinate. The clinical data were retrospectively analyzed. Neer and Chigira’s criteria of X-ray healing of bone cyst was adopted to evaluate the local curative effect. Visual analog scale(VAS) and Oswesty disability index(ODI) were used to assess the pain degree and the daily activity dysfunction. Results A total of 16 lesions were detected in the 12 patients. The success rate of puncturing was 100%. After treatment, the local pain was relieved in all patients. The cure rates of local lesions at 1, 3, 6 and 12 months after treatment were 25%, 62.5%, 87.5% and 100%respectively. Three months after treatment, the mean VAS score decreased from preoperative 8 points to postoperative one point, and the mean ODI decreased from preoperative 56.5% to postoperative 8.5%. No serious complications or death occurred. Conclusion For the treatment of spinal EG, CT-guided percutaneous local injection of lidocaine plus methylprednisolone sodium succinate is safe and minimally-invasive with reliable curative effect and obvious pain relief. Therefore, it is an effective therapeutic means.(J Intervent Radiol, 2021, 30: 466-469)