经皮球囊扩张椎体后凸成形术治疗脊柱转移性肿瘤临床观察  

Clinical Curative Effect Observation of PKP Treatment of Spinal Metastatic Tumor

作　　者：徐忠龙[1] 季卫锋[2] 马镇川[2] 祝文斌[1] 金淼夫[1] 

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]浙江中医药大学附属第一医院,浙江杭州310006

出　　处：《中医学报》2013年第9期1271-1272,共2页Acta Chinese Medicine

摘　　要：目的:探讨经皮球囊扩张椎体后凸成形术(PKP)治疗脊柱转移性肿瘤的安全性和短期临床疗效。方法:脊柱转移性肿瘤30例40椎,术前均有顽固性背痛,无神经症状。CT及MRI示脊柱肿瘤转移灶呈多发性溶骨性破坏,2椎肿瘤累及椎体后壁。在C型臂透视机透视下,经椎弓根穿刺途径进入病椎内,先取病椎病理作活检,然后置入可扩张球囊,复位塌陷的病椎,注入面团期骨水泥稳定病椎。结果:30例40椎均手术顺利,术后无脊髓神经根受损表现,48 h内疼痛均缓解,未发现骨水泥栓塞等并发症。术后X线片复查示肿瘤灶被骨水泥充填,无骨水泥超过椎体后缘,病理性骨折的椎体高度得以恢复。患者可负重行走。结论:应用球囊扩张椎体后凸成形术治疗脊柱转移瘤,能微创地同时处理多个病灶,强化病椎,提高生活质量,近期疗效满意。Objective：To evaluate the safety and efficacy of transpedicular balloon kyphoplasty for multiple vertebral metastases. Methods Forty vertebrae in 30 patients with metastatic spinal tumors had been treated by balloon kyphoplasty. All patients complained of stubborn pain. No patient s had neurologic symptoms or signs preoperatively. Based on CT or MR scanning, the lesions show ed the signs of multi- ple and osteolytic destruction, and posterior vertebral wall was involved in 2 vertebrae. Under the C arm X-ray machine perspective,is entered into the disease inside the vertebral pedicte puncture route,first take disease vertebral biopsy pathology, and then put into ex- panding balloon, reduction and disease of vertebral collapse,injected into the dough stage of vertebral bone cement stable disease. Re- suits All patients tolerated the procedure well with immediate relief of back pain with in 48 hours. The lesions were packed with cement. There was no leakage of cement into the epidur al space. The height restoration of vertebral was confirmed by X-ray examination. The patients could walk after the procedure. Conclusion Percutaneous Kyphoplasty of vertebral metastases is a minimal invasive procedure that could deal with multiple lesions and relieve pain, which effectively improves the life quality.

关 键 词：脊柱转移性肿瘤 经皮球囊扩张椎体后凸成形术 脊柱穿刺 

分 类 号：R273[医药卫生—中西医结合]