Clinical Study Of Percutaneous Vertebroplasty Combined With¹²⁵? Seeds Implantation In The Treatment Of Patients With Posterior Vertebral Defect:A Prospective Study

Objective:To analyze the safety and efficacy of percutaneous vertebroplasty combined with interstitial treatment of 125I of seeds(PVPI)in the treatment of patients with posterior vertebra defect.Methods:60 patients with spinal vertebral metastases diagnosed and treated in our hospital from May 2018 to May 2019 were divided into an experimental group(30 cases)and a control group(30 cases),the experimental group as the trailing wall defect in patients with vertebral bodies,improvement on the key techniques of PVPI,by using secondary seal and cant push needle injection of bone cement rotary filling technology to reduce leakage,a total of 42 section vertebral body treatment.In the control group,there was no defect in the posterior wall of the vertebral body,and 50 vertebral bodies was treated by PVPI.Patients in the two groups were followed up on the 2nd day,1st month,3rd month and 6th month after the operation,respectively.Pain score(VAS score),functional status score(KPS score)and bone cement injection volume were compared between the two groups.Postoperative CT review was conducted and bone cement leakage was recorded.Kaplan-Meier method was used to compare the overall and progression-free survival of the two groups of patients.Results all the 60 patients completed the surgical treatment safely.The VAS score and KPS score of the two groups improved to different degrees on the 2nd day,1st month,3rd month and 6th month after the operation compared with that before the operation.Results:The difference between the two groups was not statistically significant(P>0.05).There was no significant difference in the amount of bone cement injected between the two groups(P>0.05).Bone cement leakage occurred in 7 vertebral sections(16.7%)in the experimental group,of which 2(4.8%)were bone cement leakage in the posterior wall of the vertebral body,5(11.9%)were paraspinal bone cement leakage,and 7(14.0%)were paraspinal bone cement leakage in the control group.No serious complications such as spinal cord injury or paraplegia occurred in either group.There was no significant difference in bone cement leakage between the two groups(P>0.05).The median overall survival(mOS)of the experimental group was 13 months,and the median progression-free survival(mPFS)was 10 months.The median overall survival(mOS)of the control group was 14 months,and the median progression-free survival(mPFS)was 10 months.The differences were not statistically significant by Log-rank test(P>0.05).Conclusions:Percutaneous vertebroplasty combined with 125I particle implantation for patients with posterior wall defect of the vertebral body,as long as the intraoperative technique is improved and attention is paid to the control of cement distribution,it has good clinical efficacy and safety.