The Clinical Study Of Percutaneous Bone Cementopalsty In Treatment Of Bone Metastases

Objective:To explore the application of percutaneous bone cement forming clinical curative effect and related technology in treatment of bone metastases.Methods:Retrospective method was used to analyze the clinical data of 33 cases of bone metastasis of extremities with treatment of percutaneous bone cementopalsty in orthopaedics(Tumor Hospital of Hebei Province), which were collected from January 2010 to January 2015. Self-paired design was used and the Visual Analog Scale(VAS) was performed for the pain evaluation before operation, 24 hours after operation and 2 weeks after operation. Meanwhile, qualities of life were also evaluated before operation and after operation for 4 weeks according to the Karnofsky standard. The changes of before and after operation were analyzed with Wilcoxon signed test. Bone cement injection was observed through X-ray after operation and then 33 cases were followed up to study the progression of primary lesion, the appearance of new lesion and death of patients.Results:Operation time of 33 cases of patients ranged from 20 to 50 minutes, volume of bone cement injection from 2 to 8ml, and amount of bleeding during operation from 5 to 16 ml.Pain scores were decreased from(8.00±2.00) before operation to(5.00±2.00) 24 hours after operation and to(5.00±1.50) 2 weeks after operation, and the differences before and after operation were statistically significant(u=-4.647, P < 0.001; u=-4.817, P < 0.001). Univariate and multivariate analysis showed that the differences of pain relief 24 hours and 2 weeks after operation among different gender and age groups were not statistically significant.Quality of life scores increased from(40.00±20.00) before operation to(60.00±30.00) 4 weeks after operation, and the difference was statistically significant(u=-3.845, P < 0.001). Univariate and multivariate analysis showed that the improvement of quality of life after operation among different gender and age groups was not statistically significant.X-ray examinations were conducted again after operation, finding that bone cement of 18 cases were filled well, and 8 cases were basically filled, and bone cement leakage phenomenon occurred in the vicinity of needle track in 7 cases. The differences of pain relief 24 hours and 2 weeks after operation were not statistically significant among patients with different filling of bone cement(Fisher, P=0.807; Fisher, P = 0.245).37 bone metastatic lesions of 33 patients were observed during follow-up, with an average of 7.3 months. Results showed that 2 cases died in 6 months and 4 cases died during 6~12 months. Bone metastatic lesions of 25 cases were stable and new bone metastatic lesions were happened in 3 cases, and lesions were extended and pain aggravated in 2 cases, and pathological fracture in primary lesion was happened in 1 case.Conclusion: The clinical effect of percutaneous bone cementoplasty in treatment of bone metastases of extremities are remarkable, obviously alleviating pain of affected extremity, and improving quality of life after operation. Moreover, this operative approach also has advantages of less trauma, fewer complications, and quicker recovery after operation. With the further development of the operation method, this technology in the treatment of bone metastases of extremities will be used more widely.