Safety and efficacy of multilevel vertebroplasty for painful osteolytic spinal metastases: a single-centre experience
Safety and efficacy of multilevel vertebroplasty for painful osteolytic spinal metastases: a single-centre experience
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多节段椎体成形术治疗疼痛性溶骨性脊柱转移瘤的安全性和有效性：单中心经验
DOI：
10.1007/s00330-016-4683-x
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发表时间：
2017-08-01
影响因子：
5.9
通讯作者：
Yao, Yang
中科院分区：
文献类型：
--
作者：
Zhang, Jian-Jun;Zhou, Yan;Yao, Yang
目的回顾性评价经皮椎体成形术（PVP）治疗每次治疗3块以上椎骨的疼痛性溶骨性脊柱转移瘤的安全性和有效性。方法对153例疼痛性溶骨性脊柱转移瘤患者进行PVP治疗。 A 组患者 (n= 93) 每次疗程最多接受三个椎骨水平的 PVP。 B 组患者 (n=≥60) 在一次疗程中接受了三个以上级别的 PVP。在 PVP 之前和之后评估疼痛、生活质量 (QoL) 和活动能力。对轻微和主要并发症进行了系统评估。结果干预后，两组患者的疼痛均得到显着缓解，生活质量也得到改善（p< 0.001）。尽管与 A 组相比，B 组在 PVP 前的活动能力较差，但两组的活动能力均得到改善。在整个随访期间，两组在总体疼痛缓解以及生活质量和活动能力改善方面没有显着差异。各组之间的轻微和主要并发症也没有显着差异。结论多节段椎体成形术对于治疗多发性溶骨性脊柱转移瘤是安全有效的。多节段PVP可缓解疼痛，改善生活质量和活动能力。要点•经皮椎体成形术对于疼痛性溶骨性脊柱转移瘤安全有效。•多节段椎体成形术不会比单节段椎体成形术引起更多并发症。•多节段椎体成形术后多节段脊柱转移瘤患者可能会恢复功能独立。
ObjectiveTo retrospectively assess the safety and efficacy of percutaneous vertebroplasty (PVP) for painful osteolytic spinal metastases when treating more than three vertebrae per session.MethodsA total of 153 patients with painful osteolytic spinal metastases underwent PVP. Group A patients (n= 93) underwent PVP at up to three vertebral levels per session. Group B patients (n= 60) underwent PVP at more than three levels in one session. Pain, quality of life (QoL), and mobility were assessed before and after PVP. Minor and major complications were systematically assessed.ResultsBoth groups experienced significant pain relief and QoL improvement after the intervention (p< 0.001). Mobility improvement was observed in both groups, despite worse mobility status before PVP in group B compared with group A. There was no significant difference between the two groups throughout the follow-up period in overall pain relief and improvement in QoL and mobility. There was also no significant difference between groups in minor and major complications.ConclusionsMultilevel vertebroplasty is safe and effective for the treatment of multiple osteolytic spinal metastases. Multilevel PVP relieves pain and improves QoL and mobility.Key Points•Percutaneous vertebroplasty is safe and effective for painful osteolytic spinal metastases.•Multilevel vertebroplasty does not cause more complications than single-level vertebroplasty.•Multiple spinal metastases patients may regain functional independence after multilevel vertebroplasty.