Minimal Invasive Treatment: Percutaneous Vertebroplasty for Metastatic Spinal Tumors

微創手術：經皮穿刺骨水泥注射術在轉移性脊椎腫瘤的臨床成效

洪偉翔(Wei-Hsiang Hung) ； 牛自健(Chi-Chien Niu) ； 賴伯亮(Po-Liang Lai) ； 傳再生(Tsai-Sheng Fu) ； 蔡宗廷(Tsung-Ting Tsai) ； 黃澤波(Chak-Bor Wong) ； 游家偉(Chia-Wei Yu) ； 陳力輝(Lih-Huei Chen) ； 陳文哲(Wen-Jer Chen)

《Journal of Orthopaedic Surgery Taiwan》 27卷1期 (2010/03) Pp. 21-27

並列摘要

Purpose: Percutaneous vertebroplasty (PVP) has been used to treat patients with painful osteoporotic spinal compression fractures and benign spinal tumors such as hemangiomas. Patients with metastatic spinal tumor lesions may suffer from severe back pain due to destructive vertebral lesions associated with instability. We evaluated the clinical outcome of injecting polymethylmethacrylate (PMMA) into the vertebral body with metastatic tumor lesions.
Materials and methods: Nineteen patients with metastatic spinal tumors received PVP over a total of 25 vertebrae for pain control. The follow-up periods were from September 2003 to August 2008 and ranged from 1 to 48 months. Pain levels were assessed using the visual analog scale (VAS) before the operation, on postoperative day 3, and at 1 and 6 months during follow-up. Patients self-recorded functional disability values were obtained using the Oswestry Disability Index (ODI).
Results: Sixteen patients (84%) had moderate to marked improvement in pain on postoperative day 3. The mean VAS pain score decreased from 7.8 to 3.5 on postoperative day 3 and to 4.2 at 6 months postoperatively. The mean ODI score improved from 79 preoperatively to 53 at postoperative month 1. Seven patients (36.8%) with cement leakage had no further clinical symptoms. The majority of patients (73.7%) survived for more than 6 months after treatment. There were no postoperative neurological deficits or procedure-related complications.
Conclusion: PVP is a palliative and safe surgery option that provides moderate to marked pain relief and reduces disability in patients with symptomatic metastatic spinal tumors.

並列關鍵字

vertebroplasty ； metastasis ； spine ； bone cement