射频消融联合人工骨椎体成形治疗脊柱转移瘤的疗效分析  

Effects of radiofrequency ablation combined with percutaneous vertebroplasty by the injection of artificial bone for metastatic spinal tumor

作　　者：韦溦[1] 刘洋[1] 杨星华[1] 官正华[1] 金宏伟[1] 谢志坚[1] 叶峰[1] 

机构地区：[1]解放军第324医院创伤显微外科,重庆400020

出　　处：《局解手术学杂志》2015年第1期55-57,共3页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市卫生局医学科研项目(NO.2013-2-299)

摘　　要：目的探讨射频消融(RFA)联合注射用人工骨椎体成形术(PVP)治疗脊柱转移瘤的疗效。方法 58例脊柱转移瘤患者随机分为骨水泥1组(n=12)、人工骨1组(n=16)、骨水泥2组(n=16)、人工骨2组(n=14),骨水泥组行RFA注射用Ⅲ型丙烯酸树脂骨水泥PVP,人工骨组行RFA联合自固化磷酸钙人工骨PVP。对比分析各组术前及术后1周、1个月、3个月、6个月、9个月、12个月椎体形态及骨折发生率,以及视觉模拟评分(VAS),脊柱ODI评分。结果术后随访12个月内骨水泥组12例(42.9%)出现手术椎体或周围椎体变形,显著高于人工骨组(6.7%)(χ2=8.476 8,P=0.003 6)。各组术后VAS及ODI评分均较术前显著降低(P<0.01),骨水泥组术后6、9、12个月高于人工骨组(P<0.05)。结论 RFA联合骨水泥或人工骨PVP治疗脊柱转移瘤均效果显著,人工骨PVP疗效维持时间更持久。Objective To explore the effects of radiofrequency ablation （ RFA） combined with percutaneous vertebroplasty （ PVP） by the injection of artificial bone for metastatic spinal tumor. Methods Fifty-eight patients with metastatic spinal tumors were divided into bone cement group 1 （n=12）,bone cement group 2 （n=16）, artificial bone group 1 （n=16）, artificial bone group 2 （n=14）. The patients in bone cement group were arranged RFA combined with PVP by injection of bone cement,and the artificial bone group were treated with RFA combined with PVP by injection of artificial bone. The vertebral body modality,fractures, and visual analogue scale （ VAS） ,spinal ODI score were compared before operation,1 week,1,3,6,9,12 months of after operation. Results There were 12 patients （42. 9%） with vertebral body deformation in bone cement group,which was more than those in artificial group （6. 7%） （χ2 =8. 4768,P=0. 0036）. The VAS or DOI score decreased after operation than those pre-operation in the 4 groups （P〈0. 01）,but increased in bone cement group after operation of 6, 9 and 12 months than those in artificial group （P〈0. 05）. Conclusion The combination of RFA and PVP by injection of bone cement or＆amp;nbsp;artificial bone is effective to metastatic spinal tumors. The effects of PVP injection with artificial bone maintains longer duration compared to bone cement.

关 键 词：射频消融 椎体成形术 人工骨 骨水泥 

分 类 号：R681.5[医药卫生—骨科学] R61[医药卫生—外科学]