经皮椎体成形术治疗枢椎椎体转移瘤的穿刺途径及疗效初探  

Percutaneous vertebroplasty for treatment of metastatic tumor in axis

作　　者：孙钢[1] 金鹏[1] 易玉海[1] 刘训伟[1] 李凡东[1] 谢志勇[1] 张绪平[1] 李敏[1] 

机构地区：[1]济南军区总医院医学影像科,250031

出　　处：《中华放射学杂志》2010年第4期421-423,共3页Chinese Journal of Radiology

摘　　要：目的探讨采用前外侧或后外侧入路穿刺椎体成形术（PVP）治疗枢椎转移瘤的安全性和疗效。方法对10例枢椎椎体溶骨性转移瘤的患者行PVP，男8例，女2例。9例在x线透视引导下，采用前外侧入路穿刺与注射骨水泥，1例采用CT引导后外侧入路穿刺。结果10例患者均为单侧穿刺，并均穿刺成功。注射骨水泥量为2～4ml。患者术后当日CT复查显示骨水泥填充病灶均在70％以上。无穿刺途径出血或骨水泥外溢引起的有临床症状的并发症。术后7d内疼痛完全缓解（CR）7例，部分缓解（PR）3例。术后1周内均去掉头托承重，下床活动。术后随访3—24个月，4个月死亡2例、8～11个月死亡3例、13～15个月死亡4例、1例术后第24个月仍存活，术后均无局部疼痛症状加重的表现。结论采用前外侧入路或后外侧入路行PVP治疗枢椎转移瘤安全、有效。Objective To explore the safety and effectiveness of percutaneous vertebrophasty（PVP） in the treatment of the metastatic tumor involved axis. Methods Ten patients （8 mule, 2 female） with osteolytic metastases involved axis were treated with PVPs. The anterolaterul approach with fluoroscopy guidance was selected in 9 cases, while the posterolateral approach with CT guidance was selected in 1 ease. Results Successful unilaterul-paracentesis for PVP were achieved in all patients without intervention related complications such as bleeding and symptomatic polymethylmethacrylate （PMMA） leakage. CT scan taken following PVP showed that over 70% of the osteolytic metastatic area was well filled with PMMA in all cases. Varying degrees of pain relief were observed （CR in 7 eases, PR in 3 cases） within 7 days. All patients could support their heads without brackets. During a 3 to 24 months follow up after the procedures, No aggravated pain was found in the group. Two patients died in 4 months, 3 Patients died in 8 to 11 months 4 patients died in 13 to 15 months, and 1 patient still was alive after 24 months. Conclusion Anterolaterul or posterolateral approach to Aixs in PVP is safe and effective in treating osteolytie metastatic tumors.

关 键 词：枢椎 肿瘤转移 放射学 介入性 聚甲基丙烯酸类 

分 类 号：R687.3[医药卫生—骨科学]