经双侧椎弓根通道椎体后凸成形术治疗胸腰椎椎体转移性肿瘤  

Kyphoplasty via Bilateral Vertebral Pedicle Channel in the Treatment for Thoracolumbar Vertebral Metastatic Tumors

作　　者：赵晓峰[1] 龚剑秋[2] 钱宇[1] 张军[1] 

机构地区：[1]浙江省绍兴市人民医院骨科,绍兴312000 [2]浙江省绍兴市人民医院康复科,绍兴312000

出　　处：《中国中西医结合外科杂志》2014年第1期31-34,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨经皮双侧椎弓根通道椎体后凸成形术在胸腰椎椎体转移性肿瘤治疗中的临床疗效和安全性。方法:对17例胸腰椎椎体转移性肿瘤患者共25椎节行经皮双侧椎弓根通道球囊扩张,骨水泥注入。对患者疼痛程度及功能障碍情况分别采用视觉模拟评分和功能障碍指数于治疗前后进行评估。对骨水泥渗漏情况,各例术后以正侧位X线平片判断骨水泥渗漏为X线平片渗漏率,以注射节段CT薄层扫描评判骨水泥渗漏为CT渗漏率,进行统计计算。结果:所有患者均顺利完成手术,无一例症状性骨水泥渗漏发生。术后胸腰背痛缓解明显。VAS评分术前为(7.2±1.1)分、术后3 d内为(2.3±0.9)分、术后3个月为(2.5±1.1)分。ODI评分术前为(70.1±1.1)分、术后3 d内为(33.1±1.2)分、术后3个月为(35.2±1.4)分。计算得骨水泥X线平片渗漏率为32%,CT渗漏率为38%。结论:经皮椎体后凸成形术可有效缓解椎体转移性肿瘤患者腰背部疼痛,改善患者日常生活功能;双侧穿刺通道可降低骨水泥渗漏率及减少症状性骨水泥渗漏发生。Objective To investigate the clinical efficacy and safety of the kyphoplasty via percutaneous bi-lateral pedicle channels in the treatment for thoracolumbar vertebral metastatic tumor. Methods Totally 17cases,and 25 vertebral segments with thoracolumbar vertebral metastatic tumors underwent kyphoplasty via bilat-eral pedicle channel, balloon expansion, and bone cement injection. The degree of pain and dysfunction of pa-tients were assessed with visual analogue scale before and after treatment. Lateral view of X-ray plain film wasused to assess the leakage situation of bone cement for all the cases postoperatively. Fine cut CT scanning of theinjected segments was used to assess the leakage of bone cement. Results All patients underwent the sur-geries, and no symptomatic bone cement leakage occurred. The preoprative VAS was 7.2±1.1, and VAS ws 2.3±0.9 and 35.2±1.4 at 3 days and 3 months postoperatively respectively.The leakage rate was 32% based on X-rayand 38% based on CT scanning. Conclusion the kyphoplasty via percutaneous bilateral pedicle channels willreduce the pain of the thoracolumbar vertebral metastatic tumor effectively.

关 键 词：椎体后凸成形术 椎体转移性肿瘤 双侧通道 骨水泥渗漏 

分 类 号：R739.92[医药卫生—肿瘤]