椎体后凸成形术治疗椎体转移性肿瘤的疗效和安全性观察

摘要

目的：观察球囊扩张椎体后凸成形术（PKP）治疗椎体转移性肿瘤的疗效和安全性。方法采用PKP治疗24例椎体转移性肿瘤患者，共37节椎体。采用视觉模拟评分法（VAS）对患者术前、术后3d、术后1个月、术后3个月、术后6个月进行疼痛评分，同时记录术后下地活动时间来观察其疗效。记录术后骨水泥填充情况，肿瘤复发情况，相关并发症及不良反应，观察其安全性。结果24例患者均成功实施手术，术后3d、术后1个月、术后3个月、术后6个月的VAS评分分别为（2.04±0.95）、（1.91±0.88）、（1.87±0.94）、（2.12±0.94），明显低于术前的（7.79±0.93）（P<0.05）。24例患者中，1例患者发生椎体肿瘤再转移，37个椎体中有3个椎体发生骨水泥向椎旁渗漏。所有患者均未出现感染、深静脉栓塞等并发症。结论 PKP在治疗椎体转移性肿瘤方面安全可靠，具有良好的止痛作用，能显著提高患者生活质量。%Objective To observe the treatment and safety of metastatic spinal tumors by percutaneous Kyphoplasty. Methods The 37 vertebraes in 24 patients with metastatic spinal tumors were performed by percutaneous kyphoplasty(PKP).The treatment were assessed through the mean time of off-bed, the pre-operative visual analog scale(VAS)and the post-operative VAS on day 3, months 1, 3, and 6. Safety assessment was conducted based on complications, cement leakage, adverse events and tumor recurrence. Results All 24 patients tolerated the procedure of PKP successfully.Postoperative VAS scores were significantly lower than the pre-operative VAS(7.79±0.93)on day 3(2.04±0.95), months 1 (1.91±0.88), 3(1.87±0.94), and 6(2.12±0.94),respectively(P<0.01).The tumor recurrence occurred in a patient,Cement leakages were detected at 5 of 37 vertebraes,which were 2 with intra-disc leakage, and 3 with paravertebral leakage.Without the infection of incisional wound, deep vein thrombosis(DVT)and other complications. Conclusions PKP is a safe and effective minimally invasive therapay,which can effectively relieve the pain and improve the quality of life in patients with metastatic spinal tumors.