骨水泥剂量差异对椎体成形术治疗胸腰椎转移瘤时效性及安全性影响

Thein Fluence of Different Amount of Cement on the Effectiveness and Safety of Vertebroplasty for Thoracolumbar Metastases

目的:探讨使用中低剂量骨水泥差异是否对椎体成形术治疗胸腰椎转移瘤手术后效果的影响。方法:使用回顾性队列分析方法,收集茂名市人民医院2013年2月-2020年2月收治的胸腰椎转移瘤患者61例的临床资料。术中记录椎体骨水泥注射总量,根据患椎平均骨水泥注入量,分为中等剂量组与低剂量组,中等剂量组注入量>3ml/椎体(37例);低剂量组注入量2-3ml/椎体(24例)。比较2组患者手术前与手术后1周、3个月时,功能障碍指数评分、视觉模拟量表评分、并发症发生情况。结果:2组患者各项指标均较手术前显著改善,组内比较术前术后差异具有显著性(P<0.05),术后1天与术后1周,3个月差异无显著性;2组间数据功能障碍指数评分视觉模拟量表评分比较差异无显著性(P>0.05)。低剂量组骨水泥渗漏发生率为16.6%,明显低于中剂量组43.2%,差异具有显著性(P<0.05),但2组间发热及下肢麻木并发征发生率无显著差异。结论:PVP治疗胸腰椎转移瘤微创有效,短期疗效显著,注入小剂量骨水泥也可达到满意疗效。同时,小剂量注入可减少骨水泥渗漏的发生。

Objective:To investigate the effect of bone cement dose difference on the treatment of thoracolumbar metastases by vertebroplasty.Methods:Retrospective cohort analysis was used to collect the clinical data of 61 patients with thoracolumbar metastases admitted in Maoming Peoples Hospital from February 2013 to February 2020.the total amount of vertebral bone cement injection was recorded during the operation.according to the mean bone cement injection volume of affected vertebrae.It was divided into medium dose group and low dose group,medium dose group>3 mL/vertebral body(37 cases),and low dose group was injected 2-3 mL/vertebral body(24 cases).Comparison between two groups before treatment and At one week and three months postoperatively,the index score of dysfunction,the visual analog scale score,and the occurrence of complications.Results:All the indexes of the two groups were significantly better than before treatment,the difference between the two groups was significant(P<0.05),the difference between one day after operation and one week after operation,and the difference between the two groups was not significant(P>0.05).Bone cement leakage rate in low dose group was 16.6%,which was significantly lower than that in middle dose group(43.2%P<0.05).There was no significant difference in the ineidence of fever and numbness complications.Conclusion:The PVP treatment of thoracolumbar metastases is efective and effective,and the short-term effect is remarkable.At the same time,low dose injection can reduce the occurrence of bone cement leakage.