Efficacy Of Open Decompression Internal Fixation,Microwave Ablation Combined With Vertebroplasty In The Treatment Of Metastatic Tumors Of The Spine

Objective:A retrospective comparison of the clinical efficacy and safety of open posterior decompression and internal fixation combined with microwave ablation vertebroplasty and open posterior decompression combined with vertebroplasty in the treatment of 58 cases of spinal bone metastases.Methods:Retrospective analysis of 113 patients with secondary malignant tumors of the spine treated by our department from January 2018 to December 2021,and 58 patients met the inclusion criteria.The patients were divided into observation group and control group according to the different procedures,including 28 cases treated with open posterior decompression and internal fixation combined with microwave ablation vertebroplasty(observation group)and 30 cases treated with open posterior decompression combined with vertebroplasty(control group).The general data of the two groups were collected using the self-made "General Information Registration Form".X-ray radiograph scans were completed immediately after surgery to observe the status of intraoperative complications and to record the status of postoperative complications in both groups as an index for evaluating the safety of treatment in both groups.Patients were followed up preoperatively,1 week,1 month,3 months and 6 months after surgery to understand the trend of changes in pain level(VAS score),physical status(KPS score),recovery of neurological function(Frankel rating)and spinal stability(SINS score),which were used as evaluation indexes of treatment efficacy in the two groups.Results:1.The general data of the control group and the observation group were compared,including demographic status-related information such as gender(male/female)distribution,age(mean,standard deviation)distribution,socio-cultural development level(junior high school and below/college undergraduate/graduate and above)distribution,residence(living alone/family living together)distribution status,marriage(unmarried/married/divorced)distribution,monthly household income distribution,Medical insurance payment method,smoking and drinking status,comorbidities and other status,and data related to disease status such as primary tumor classification of spinal lesion metastasis(lung cancer,thyroid cancer,liver cancer,kidney cancer,prostate cancer,esophageal cancer and others),postoperative radiotherapy treatment,duration of surgery,modified Tokuhashi score,Tomita score were compared,and the differences were not statistically significant P-value was greater than 0.05.The intraoperative bleeding volume and postoperative drainage volume in the observation group were smaller than those in the control group,which were statistically significant,and the P-value was less than 0.05.2.Both the control group and the observation group had successfully completed the surgery and no events such as death occurred during the surgery,and the technical success rate was 100%.No serious complications occurred in both the control group and the observation group after surgery,and the postoperative complication rate in the observation group was 7.1%,which was lower than that in the control group was 30.0%,and the difference was statistically significant,and the P-value was less than 0.05.3.In the preoperative period,there was no statistically significant difference between the pain level(VAS score),physical strength status(KPS score),recovery of neurological function(Frankel classification),and spinal stability(SINS score)in the control and observation groups,and the P value was greater than 0.05;compared with the preoperative period,at 1 week,1 month,3 months,and 6 months after surgery,the pain relief in the control and observation groups(VAS score)and spinal stability(SINS score)decreased sequentially,while physical status(KPS score)and neurological recovery(Frankel classification score)improved sequentially in both the control and observation groups compared to the preoperative period,with P values less than 0.05.At 1 week,1 month,3months,and 6 months after surgery,pain relief(VAS score)and spinal stability(SINS There was no statistical difference between groups in the recovery of neurological function(Frankel classification score).Conclusion:1.Open posterior decompression and internal fixation combined with microwave ablation vertebroplasty for the treatment of spinal metastatic tumors has a high technical success rate and is highly operable.2.Compared with posterior open decompression combined with vertebroplasty,open posterior decompression and internal fixation combined with microwave ablation vertebroplasty has fewer complications and better efficacy in the treatment of spinal metastatic tumors,which is demonstrated by rapid and pain control,reconstruction of spinal function,and improvement of patients’ quality of life and survival status.