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目的探讨经皮椎体成形术(PVP)治疗硬膜侵犯溶骨性胸腰椎转移癌的临床疗效。方法回顾性分析自2011-08—2015-01采用PVP治疗的21例硬膜侵犯溶骨性胸腰椎转移癌,比较手术前后VAS评分、ODI指数。结果 21例(30椎)均顺利完成手术,21椎经椎弓根入路穿刺,9椎经椎弓根外穿刺。本组手术时间平均21 min,单个椎体骨水泥注入量平均3 ml,住院时间平均3 d。4例出现少量骨水泥渗漏,其中1例椎体前缘渗漏,2例椎间盘渗漏,1例椎体后壁渗漏,均无严重并发症发生。本组术后1个月VAS评分、ODI指数较术前明显降低,差异有统计学意义(P<0.05)。结论 PVP治疗硬膜侵犯溶骨性胸腰椎转移癌是一种安全、有效的微创手术方式,可明显缓解患者疼痛,改善患者的生活质量。
Objective To investigate the clinical efficacy of percutaneous vertebroplasty (PVP) in the treatment of transitional carcinoma of thoracolumbar metastasis caused by dura mater. Methods 21 cases of transitional carcinoma of the thoracolumbar and lumbar metastases treated with PVP from 2011-08-2015-01 were retrospectively analyzed. The VAS score and ODI index were compared before and after operation. Results Twenty-one patients (30 vertebrae) had successful operation. The pedicle screw was punctured by 21 vertebrae and the pedicle was punctured by 9 pedicles. The average operation time of this group was 21 min, the average volume of single vertebral bone cement injected was 3 ml, and the average hospital stay was 3 days. A small amount of cement leakage occurred in 4 cases. One case had leakage of vertebral anterior margin, 2 cases of disc leakage, and 1 case of posterior vertebral wall leakage. No serious complications occurred. The VAS score and ODI index in this group were significantly lower than those before operation (P <0.05). Conclusion PVP is a safe and effective minimally invasive surgery for dura mater invasion of osteolytic thoracolumbar metastasis. It can significantly relieve pain and improve the quality of life of patients.