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目的探讨经皮椎弓根成形术治疗椎弓根溶骨性转移瘤的方法及临床应用价值方法本组18例患者,共23个椎弓根有溶骨性转移胸椎3例,腰椎15例,其中5例同时累及2个腰椎椎弓根在CT引导下,用11G或13G长15.0cm骨穿针穿剌到位后,将聚甲基丙稀酸甲脂(Polymethylmethacrylate-PMMA)粉剂、液态单体及超液态碘化油按20g:10ml:3ml的比例配制,当骨水泥呈牙膏状时,分步注入骨水泥约2.5～5ml术后随访1～18个月结果所有病例均穿刺成功根据WHO疼痛缓解程度判断其有效性,术后所有病例疼痛均有不同程度缓解所有病例未发生骨水泥渗漏所引起的椎管及椎间孔狭窄骨水泥外溢7例:5例骨水泥渗漏到肿瘤内(其中2例骨水泥同时渗漏到椎间孔内);1例骨水泥外渗到椎间孔内,出现神经根症状,经静脉输入甘露醇脱水加小剂量地塞米松对症处理,3d后症状消失;1例少量骨水泥外渗到椎管内,未引起神经压迫症状结论经皮椎弓根成形术是一种治疗椎弓根溶骨性转移瘤所致疼痛、增强脊柱稳定性的微创、安全、有效的方法
Objective To investigate the method and clinical value of percutaneous pedicle screw osteosynthesis in the treatment of pedicle osteolytic metastases Methods 18 patients in this group, a total of 23 pedicle screw osteolytic metastatic thoracic 3 cases, lumbar 15 cases, Among them, 5 cases involved two lumbar pedicles at the same time under the guidance of CT. After punctured with 11G or 13G long 15.0cm bone puncture needle, Polymethylmethacrylate-PMMA powder, liquid monomer And ultra-liquid iodized oil according to the ratio of 20g: 10ml: 3ml, when the bone cement is toothpaste, the stepwise injection of bone cement about 2.5 ~ 5ml were followed up for 1 to 18 months results in all cases were successful puncture according to WHO pain The degree of mitigation to determine its effectiveness, postoperative all cases of pain have varying degrees of relief of all cases of bone cement leakage caused by spinal canal and foramen magnified bone cement spill in 7 cases: 5 cases of bone cement leakage into the tumor (2 cases of bone cement leakage to the intervertebral foramen); 1 case of extravasation of cement into the intervertebral foramen, the emergence of nerve root symptoms, mannitol dehydration by intravenous infusion of small doses of dexamethasone symptomatic treatment, 3d Symptoms disappeared; a small amount of extravasation of bone cement into the spinal canal, did not cause nerve compression Conclusions Percutaneous pedicle screw angioplasty is a minimally invasive, safe and effective method of treating pain caused by pedicle osteolytic metastases and enhancing spinal stability