强迫性侧卧位下经皮椎体成形术治疗腰椎转移性肿瘤

摘要

Objective To evaluate the clinical outcome of percutaneous vertebroplasty (PVP) in treating metastatic tumor of lumbar spine under forced lateral position. Methods Six patients with metastatic tumor of lumbar spine were treated by percutaneous vertebroplasty (PVP) under forced lateral position between December 2014 and December 2015 in the Second Affiliated Hospital of Chongqing Medical University. Imaging data and visual analogue scale (VAS) were used to evaluate the clinical outcome of PVP. Results The operative time was from 16 to 32 min (mean 24.4 ± 4.3 min). The mean duration of follow-up was (10.0 ± 2.0) months. All images of the six patients were collected. There was no tumor recurrence or hydroxyapatite cement leakage, and there were two deaths due to multiple organ dysfunction syndrome at the time of 6-7 months after surgery. VAS varied from (6.6 ± 1.3) to (1.9 ± 1.1) after surgery (P<0.05). Conclusion PVP is effective in the treatment of metastatic tumor of lumbar spine under the forced lateral position.%目的 探讨强迫性侧卧位下行经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗腰椎转移性肿瘤的手术技巧及临床疗效.方法 回顾性分析2014年12月至2015年12月于我科治疗的因无法耐受俯卧位而采用强迫性侧卧位下行PVP的6例腰椎转移性肿瘤病人,收集统计所有病人的手术前后影像学资料、疼痛视觉模拟量表(visual analogue scale,VAS)评分及肿瘤复发情况,评价强迫性侧卧位下PVP治疗腰椎转移性肿瘤的临床疗效.结果 本组病人手术时间为16~32 min,平均为(24.4±4.3)min.病人均获得随访,随访时间为6~12个月,平均为(10.0±2.0)个月.术后所有病人至末次随访均未见肿瘤破坏加重,其中2例病人于术后6~7个月死于多器官功能衰竭.所有病人术前、术后影像学资料完整,均无骨水泥外漏,术中无骨水泥反应,术中、术后无脊髓、神经根损伤等并发症发生,术后无穿刺部位感染.病人术前VAS评分为(6.6±1.3)分,与术后的(1.9±1.1)分比较,差异具有统计学意义(P<0.05).结论 腰椎转移性肿瘤病人采用强迫性侧卧位,行PVP手术可有效缓解病人疼痛,取到较好的临床疗效.