Percutaneous vertebroplasty for thoracic vertebral metastasesPercutaneous vertebroplasty for thoracic vertebral metastases
李健;黄海;潘永谦;张平;杨波;莫世奋;
摘要(Abstract):
[背景]脊柱转移瘤是最常见的骨转移瘤,高达40%的癌症患者发生脊柱转移[1]。脊柱转移瘤常常引起椎体骨折、脊柱不稳、脊髓及神经根压迫等及其他合并症。手术治疗的目的在恢复脊柱稳定性的同时解除神经压迫的因素。[方法]从2003年1月~2009年7月,21例胸椎转移瘤患者(女12例,男9例;平均年龄58.3岁)行经皮穿刺椎体成形术PVP(percutaneous vertebroplasty)治疗,并对患者术前、术后(1周、6个月及1年)进行随访调查,通过视觉模拟评分法(VAS)、日常生活自理能力(ADL)量表进行评价。[结果]21例手术均成功,椎体成形术中平均每个椎体骨水泥(PMMA)注射量约(2.9±0.3)ml(1.7~4.1 ml)。大部分患者94%(19/21)、88.2%(15/17)、100%(14/14)术后短期及长期均有良好的治疗止痛效果,术前VAS平均8.38±0.653降至术后1年随访内平均2.69±1.75。根据ADL评分,大部分患者无伴疼痛或伴轻微疼痛,其总体生活质量均有所提高。[结论]经皮穿刺椎体成形术(PVP)是缓解胸椎转移瘤引起顽固性疼痛一种安全、有效、简单的治疗手段。其通过增加椎体强度、提高脊椎的稳定性防止病椎塌陷引起的脊髓受压产生的神经功能障碍,同时降低了椎管内肿瘤的浸润。PVP可能成为缓解椎体转移瘤导致疼痛的一种治疗手段。
关键词(KeyWords): 椎体成形术;胸椎转移瘤;疼痛;骨水泥
基金项目(Foundation):
作者(Author): 李健;黄海;潘永谦;张平;杨波;莫世奋;
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参考文献(References):
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