| Objective To discuss the clinical feasibility、safty and the effectiveness of combining percutaneous vertebroplasty and 125 I seeds implantation in treatment of spinal metastasis,and make a comparision of clinical effectiveness between solitary percutaneous vertebroplasty(Solitary group) and percutaneous vertebroplasty plus 125 I seeds implantation(Combination group).Method 120 cases spinal metastasis which were treated on my department which 70 cases were treated by solitary percutaneous vertebroplasty and 50 cases were treated by percutaneous vertebroplasty plus 125 I seeds implantation.visual analogue scale(VAS) score and KPS were used to evaluate the clinical improvement between preoperation and postoperation, and evaluate the increase or descrease of tumor lesions through the Computer tomography(CT) or Maganetic resonace imaging(MRI) of preoperation and post-operation, and make a comparision between solitary percutaneous vertebroplasty and percutaneous vertebroplasty plus 125 I seeds implantation.Result The technical success rate of procedure is 100%.Solitary group:Mean VAS score dropped from preoperative 7.9±0.8 to 5.8±0.9 postoperative 1 day,4.3±1.2 postoperative 1 months, 3.3±1.3 postoperative 3 months, 2.5±1.9postoperative 6 months. Mean KPS score increased from preoperative37±10.2 to 44.9±8.9 postoperative 1 day, 60.3±9.9 postoperative 1 months,68.9±10.4 postoperative 3 months, 71.0±9.0 postoperative 6 months. The local effective rate was up to 81.4% postoperative 1 month, 77% postoperative 3 months, 84.2% postoperative 6 months; Combination group : Mean VAS score dropped from preoperative 7.7±0.8 to 5.8±1.2postoperative 1 day, 3.1±0.9 postoperative 1 months, 2.4±1.4 postoperative3 months, 1.9±1.4 postoperative 6 months. Mean KPS score increased from preoperative 35.8±7.8 to 42.8±7.3, postoperative 1 day, 66.4±8.5postoperative 1 months, 73.6±9.4 postoperative 3 months, 83.8±10.5postoperative 6 months. The local effective rate was up to 88%postoperative 1 month, 90% postoperative 3 months,86% postoperative 6months; the comparision of solitary and Combination group:The comparision of VAS and KPS in every group have significant difference(P<0.05). The comparision of VAS and KPS postoperative 1 day of solitary group and combination group have no significant difference(t=-0.091,P>0.05;t=1.06,P>0.05),while postoperative 1 month、 3 months and 6 months have significant difference.Solitary group: the bone cement was(4.6±0.8)ml/vertebral body. The leakage rate was 64.8%. radiculalgia pain(1 case) and others were asympatomatic.Combination group: the bone cement was( 4.0±0.7) ml/vertebral body.The seeds were(30±2) per vertebral body. The leakage rate of bone cement was 57.7%. radiculalgia pain(1 case), 125 I seeds deviration(1 case) 、 radioactive edema(2 cases).Others were asympatomatic.Conclusion: Percutaneous vertebroplasty is an safty and Feasiblility procedure, which can relieve the pain result from spinal metastasis and control the growth of tumors and improve the quality of life.When the conventional methods,such as surgery、radiotherapy and chemotherapy,have no role in relieving the symptom of spinal metastasis,percutaneous vertebroplasty can be used to treat spinal metastasis. Percutaneous vertebroplasty plus 125 I seeds implantation were also relieve the pain 、control the growth of tumor and improve the quality of life. Compared with the percutaneous vertebroplasty, percutaneous vertebroplasty plus 125 I seeds implantation have an superior to relieving the pain 、physical improvement and control the growth of tumors. |
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