Clnical Study of the Treatment of Patients with a Metastatic Spinal Tumor by Percutaneous Vertebroplasty under the Guidance of DSA

摘要

OBJECTIVE To explore the clinical effect in patients with metastatic spinal tumors treated by percutaneous vertebroplasty (PVP ) under the guidance of digital subtraction angiography (DSA ). METHODS A total of 110 cases with a metastatic spinal tumor were divided into 55 cases in the treatment group (group A ) and 55 cases in the control group (group B ). The general clinical data were statistically analyzed before treatment with the parameters showing no differences. Group A was treated by PVP and chemotherapy as well. Group B was treated by the regular chemotherapy and regular radiation therapy. The same chemotherapy program was used for the same type of disease. All cases were provided with a follow-up survey for 12 months. During the follow-up survey, changes in the quality of life, in evaluation of bone pain and in vertebral column stability as well as adverse reactions were observed. RESULTS The statistics showed a significant difference between the 2 groups, specifically changes in the quality of life and evaluation of bone pain (P < 0.05, t_1=2.74, t_2=9.02). During the follow-up survey, 5 cases in group A died of other organ complilcations, the death rate being 9.1% (5 out of 55), but all survived more than 3 months following PVP. The vertebral columns of the survivors were kept stable, with no pathological fractures occurring in the vertebral bodies filled with bone cement, there were no obvious adverse reactions, and no paraplegia occurred. Thirteen cases died in group B with a death rate of 23.6% (13 out of 55). Pathological compression fractures in the vertebral bodies occurred in 30 cases, and 12 cases of complicated paraplegia were noted. The incident rate of paraplegia was 21.8% (12 out of 55). CONCLUSION PVP is a simple operation causing only small wounds and few complications. It can effectively alleviate pain of metastatic spinal tumors in patients, improve quality of life and reduce the incidence rate of paraplegia.