影像引导下空心螺钉联合骨水泥固定技术治疗髋臼转移肿瘤一例报告  

Image-guided cannulated screw combined with bone cement fixation in the treatment of acetabular metastatic tumor:a case report

作　　者：陈杨 向海滨 艾克拜尔·尤努斯[1] 亚地坎·亚生江 CHEN Yang;XIANG Hai-bin;Akbar:yunus;Yadikan'yashengjiang(Department of Bone Cancer,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830000,China)

机构地区：[1]新疆医科大学第一附属医院骨肿瘤外科,乌鲁木齐830000

出　　处：《中国骨与关节杂志》2023年第5期369-373,共5页Chinese Journal of Bone and Joint

摘　　要：对于骨转移性肿瘤,据统计每年多达10万例患病,其中以乳腺癌和前列腺癌骨转移率最为显著,约占骨转移癌总数的75%,膀胱癌和肺癌患者高达40%[1]。在骨转移癌中,因骨盆区在负重过程中存在巨大的压力,遂在骨转移癌中,骨盆转移的问题尤为严重[2],尤其髋臼这样解剖结构复杂的部位,切除和重建相当困难,目前尚无最佳的治疗方法[3]。Objective To evaluate the image-guided cannulated screw combined with bone cement fixation in the treatment of acetabular metastatic tumors.Methods Under the guidance of image,a patient with acetabular metastatic tumor was treated with hollow screw combined with bone cement fixation.Ischial screw,ascending branch screw,anterior and posterior screw were inserted to firmly fix the anterior and posterior column of the acetabulum.At the same time,the third screw connected the anterior and posterior columns together,combined with bone cement into the fracture site to further increase local stability and resist bone defects caused by local tumor osteolysis.The general data and operation of the patients were summarized.Differences in visual analogue scale(VAS)and walking function(MSTS)before operation,2 months,6 months and 12 months after operation were compared.Postoperative complications and tumor progression were recorded.Results The patient was followed up for 16 months and the operation time was 60 minutes.Bone cement 20ml was injected into the acetabular posterior column and the top of the acetabulum.VAS scores:8 before operation,3 at 2 months,3 at 6 months and 2 at 12 months after operation.MSTS function:13 before operation,23 at 2 months,25 at 6 months and 26 at 12 months after operation.During the follow-up,no cement leakage,fever,hip nerve injury,pulmonary embolism,or imaging findings of further destruction of the acetabulum and surrounding bone was noted.Conclusions This case report shows that the hollow screw fixation under the guidance of C-arm combined with bone cement can effectively relieve the pain of metastatic cancer and enhance the strength of the pelvis,which is innovative and feasible.

关 键 词：髋臼 肿瘤转移 骨折固定术 内 矫形外科手术 

分 类 号：R738.1[医药卫生—肿瘤]