目的:探讨CT引导下125I粒子植入联合经皮椎体成形术(PVP)治疗椎体转移性肿瘤的临床价值.方法:15例患者共累及22节椎体,1～3节/倒,其中颈椎1节、胸椎11节,腰椎10节.所有病例均在CT 引导下采用粒子针直接穿刺或粒子针通过骨水泥针同轴技术进行125I粒子植入,并采用粒子针或联合骨水泥针完成PVP治疗.结果:全部病例成功完成治疗,植入粒子数目为6～30颗/节,骨水泥量注入量为l.5～6ml/节.本组中单独采用1～3根粒子针直接完成粒子植入和PVP两种治疗有20/22节椎体(91%),联合骨水泥针完成两种治疗有2/22节椎体(9%).术后患者疼痛缓解率为86.7%.出现骨水泥渗漏3例,无脊髓和神经压迫,脊髓放射损伤等并发症.结论:CT引导下125I粒子植入联合PVP治疗椎体转移性肿瘤,近期疗效肯定,不良反应小,本组病例中绝大多数椎体仅采用粒子针完成125I粒子植入和PVP两种治疗,技术简单、安全.穿刺器材费用低,值得推广应用.%Objective: To evaluate efficiency of a combined treatment consisting of CT guided radioactive 125I seed implantation (CTRISI) with percutaneous vertebroplasty (PVP) for vertebral metastases. Methods. Fifteen patients with vertebral metastases received a combination treatment of CTRISI and PVP. The treatments were performed with seed needles alone or followed by bone cement needles. Results:Of all the 22 spinal lesions,the thoracic area (n=ll) of the spine is the most affected,followed by lumbar (n= 10) and cervical (n=1).100% of the patients achieved successful treatment. The number of 125I seeds per vertebra ranged from 6 to 30. The average volume of injected bone cement was 1. 5-6. 0ml per vertebra. The procedures could be achieved with seed needle alone in 20 (91 %) vertebrae and followed by bone cement needle in 2 vertebrae. 86. 7% of the patients had significant pain relief. There is no major complications, such as spinal cord compression,radiation injuries,except for leak of bone cement. Conclusion:The combined treatment of CTRISI and PVP is a safe and effective method for treating patients with vertebral metastases.
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