| Objective To investigate the feasibility and clinical efficacy on metastatic epidural spinal cord compression treated by separation surgery combined with vertebroplasty combined with interstitial implantation of 125I seeds.Method Research and analysis from November 2017 to June 2019 in yunnan province tumor hospital(the third affiliated hospital,kunming medical university)orthopaedic treatment of 56 cases of Metastatic epidural spinal cord compression(Metastatic epidural spine cord compression,MESCC)patients data;According to different treatment methods,26 MESCC patients completed separation surgery(control group),and 30 MESCC patients completed separation surgery combined with vertebral body shaping+125I seed intertissue implantation(experimental group),and the intraoperative blood loss was recorded at the same time.Patients in the two groups were followed up at the first week,the second month and the sixth month after the operation,respectively.Visual analogue score(VAS),functional status score(KPS)and American spinal cord injury association classification(ASIA)were recorded.chi-square test,t-test and analysis of variance were used to compare the differences and changes of various observation indicators between the two groups.Results:All the patients successfully passed the perioperative period,and systemic comprehensive treatment such as chemical drugs and targeted drugs was completed according to the treatment plan of primary malignant tumor.Intraoperative blood loss was 2803.84± 1142.45ml in the control group and 2833.33± 1189.71ml in the experimental group.There was no significant difference in blood loss between the experimental group and the control group(P?0.05).Changes of visual simulation score of pain:compared with the experimental group,there was no significant difference in preoperative pain degree between the control group and the experimental group(P?0.05).In the first week after the operation,the pain relief degree of the patients in the experimental group was better than that in the control group(P?0.05).2 months after the operation,the pain relief degree of the patients in the experimental group was stronger than that in the control group(P?0.05).At the 6th month after the operation,the pain of the experimental group was better than that of the control group(P?0.05).Changes in functional status score:there was no significant difference in preoperative functional status between the control group and the experimental group(P?0.05).In the first week after the operation,the functional recovery of the patients was better in the experimental group than in the control group(P?0.05).At the second month after the operation,the functional recovery of the patients was stronger in the experimental group than in the control group(P?0.05).At the 6th month after the operation,the functional recovery degree of the experimental group was stronger than that of the control group(P?0.05).Changes in ASIA grading:there was no significant difference in preoperative ASIA grading between the two groups(P?0.05).Postoperative neurological function of 20 MESCC patients in the control group was restored to different degrees(76.92%).Postoperative neurological function of 24 MESCC patients in the experimental group was recovered to different degrees(80%).There was no significant difference in the degree of neurological rehabilitation between the two groups(P?0.05).Conclusion:1.Both separation surgery and separation surgery combined with vertebroplasty and 125I seeds implantation can improve nerve function.2.Separation surgery combined with vertebroplasty and 125I seeds implantation can significantly relieve pain and improve quality of life3.Separation surgery combined with vertebroplasty and 125I seeds implantation is a novel combination technique with definite curative effect,which is suitable for MESCC patients with adjacent vertebral bodies and metastatic lesions. |
PDF Full Text Request