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目的:探讨经皮椎体成形术(PVP)治疗脊柱转移癌的疗效和并发症的防治。方法:采用PVP治疗脊柱转移癌患者15例(病椎22节),包括颈椎5例、颈椎合并胸椎1例、胸椎3例、胸腰椎同时存在1例、腰椎4例、骶尾椎合并髂骨1例。所有患者术后1～2周进行病椎放疗。结果:15例中21节病椎施术成功。术后3个月以上随访病椎部位疼痛完全消失12例,轻微疼痛3例。术后X线和CT复查发现病椎的肿瘤区域18节被骨水泥完全均匀充填加固,3节大部充填。术后15节病椎发生骨水泥外漏,1例颈椎患者术后出现声音嘶哑和吞咽困难,1例骶尾椎合并髂骨转移癌患者术后出现双足底麻木,均经保守治疗1周症状消失。结论:PVP治疗脊柱转移癌能够凝滞病变、固化椎体、缓解疼痛,结合放疗是一种治疗脊柱转移癌效果较好的微创技术。
Objective: To investigate the efficacy and complications of percutaneous vertebroplasty (PVP) in the treatment of spinal metastases. Methods: Fifteen patients with spinal metastases (22 diseased vertebrae) were treated with PVP, including 5 cases of cervical spine, 1 case of cervical spine combined with thoracic spine, 3 cases of thoracic spine, 1 case of thoracolumbar spine, 4 cases of lumbar spine, 1 case. All patients underwent radiotherapy 1 ~ 2 weeks after operation. Results: In 15 cases 21 cases of vertebroplasty was successful. Follow-up of more than 3 months after operation, the pain in the vertebral body completely disappeared in 12 cases and mild pain in 3 cases. Postoperative X-ray and CT examination found that the lesion vertebral tumor area 18 sections were completely uniformly filled with bone cement reinforcement, most of 3 filling. Postoperative 15 cases of vertebral bone cement leakage occurred in 1 case of cervical patients with hoarseness and dysphagia after surgery, 1 case of sacrococcygeal iliac metastasis of patients with bipedal numbness after conservative treatment for 1 week Symptoms disappear. CONCLUSIONS: PVP is a minimally invasive technique for the treatment of metastatic spine disease, which can stasis lesions, solidify the vertebral body and relieve pain. Radiotherapy combined with radiotherapy is a minimally invasive technique for the treatment of spinal metastases.