| Objective: Study on percutaneous vertebroplasty (percutaneousvertebroplasty, PVP) for the treatment of vertebral metastatic tumors in theprocess, in different bone cement occupied lesions of vertebroplasty fillerproportion of cases, observation of PVP postoperative clinical outcome, andthe related issues.Methods:2006April to2011March application of percutaneousvertebroplasty for the treatment of, and has a complete data of54cases ofspinal metastatic tumor patients, a total of83vertebrae, the primary tumorwere lung cancer (10cases), hepatocellular carcinoma (9cases), esophagus(4cases), gastric cancer (5cases), node colorectal cancer (n=7), renal cellcarcinoma (8cases), breast cancer (7cases), prostate cancer (4cases),through to the preoperative acquisition and regular postoperative follow up(after1days,1weeks,1months,6months) to obtain relevant data werestatistically analysed (degree of pain relief visual analog score by VASmethod and WHO method, spinal function improved using ADL score, spinalstability by measuring the operation after vertebroplasty convex Cobb angle),observe and study of bone cement filling percentage and postoperative clinicalcurative effect.Results:1In54patients the pain symptoms after surgery were improved todifferent degree, wherein, one levels filled with bone cement ratio score ofVAS from7.72±0.58to1days after the6.45±0.94,1weeks after operation,3.05±0.57,1months after the2.84±1.33,6months after the month4.23±1.17; two levels filled with bone cement ratio score of VAS from7.64±0.62to1days after the6.46±0.23,1weeks after operation,2.93±0.45,1monthsafter the2.64±1.25,6months after the4.05±1.05; three level of bone cement filling percentage score of VAS from8.71±0.32to1days after the6.82±0.45,1weeks after operation,2.89±0.34,1months after the2.58±1.30,6monthsafter the3.98±1.23; four levels filled with bone cement ratio by preoperativeVAS score9.15±0.27down to1days after the6.77±0.21,1weeks afteroperation,2.94±0.55,1months after the2.62±1.52,6months after the4.12±1.12. Before and after operation the pain level difference has statisticalsignificance (P<0.05), after different level filling proportion among groups ofpain relieving degree no statistical difference (P<0.05).254patients with postoperative spinal function were improved indifferent extent, wherein, one bone cement filling ratio in patients with ADLscore from4.364±0.326to1weeks after surgery and1.612±0.483,1monthsafter the1.518±0.476,6months after the1.539±0.501; two bone cementfilling ratio in patients with ADL score from4.278±0.374to1weeks aftersurgery and1.586±0.472,1months after the1.506±0.461,6months after the1.516±0.471; three levels filled with bone cement proportion of patients withthe score of ADL from4.746±0.517drop operation after1weeks of1.468±0.545,1months after the1.426±0.514,6months after the1.259±0.463;four levels filled with bone cement proportion of patients with ADL scorefrom4.737±0.506to1weeks after surgery and1.476±0.524,1months afterthe1.443±0.521,6months after the1.214±0.467.1days before operationand ADL scores on postoperative day7, after1months,6months after ADLscore have significant difference (P<0.05), after7days,1months after theoperation, postoperative6months ADL score difference does not havestatistical significance (P>0.05).3Bone cement filling ratio of one to four levels of bone cement leakagerate (after1days) were:1level16.7%Level2Level3;28%;35%;4grade50%, with increased, leakage rate gradually increased.4After1months,6months for routine follow-up, respectively, in spineare lateral X-ray examination, see operation vertebral body were without bonyerosion, no soft tissue mass formed in situ recurrence, spinal stability withoutdamage. Conclusion:⑴During PVP, increased bone cement filling percentage increasespostoperative bone cement leakage rate.⑵PVP preoperative, postoperative VAS and ADL score have significantdifference, PVP can effectively relieve pain in patients with symptomaticspinal metastases and improvement of spinal function, and for a long time tomaintain.⑶、After different level filling proportion among groups of pain andspinal function had no significant difference, after a follow-up of6months,there was no operation vertebral tumor recurrence in situ, description ofdifferent cement ratio and postoperative pain relief, improvement of spinalfunction and tumor recurrence in situ rate showed no significant relationship.⑷1,2,3,4level of bone cement filling ratio can be effective in restoringand maintaining spinal stability.⑸PVP technique is simple, safe, which can effectively improve thesurvival quality of patients during operation, through reasonable regulation ofbone cement filling ratio, can be guaranteed under the premise of operationcurative effect, reduce the incidence of postoperative complications in PVP. |
PDF Full Text Request