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[目的]探讨单侧椎弓根外入路经皮椎体成形(percutaneous vertebroplasty,PVP)和后凸成形术(percuta-neous kyphoplasty,PKP)治疗高位胸椎转移性肿瘤椎体破坏的可行性和安全性,评价临床疗效。[方法]2008年3月,1例T1~3肺癌转移,男性,59岁,诊断肺癌8个月,上胸椎及左侧肩部剧烈疼痛6个月,药物镇痛效果不佳,无手术可能。使用国产PVP和PKP工具包,采用局部麻醉,在透视引导下单侧椎弓根外入路完成T2和T3椎体强化。随访观察治疗效果。[结果]手术过程顺利,T3和T2椎体分别进行PKP和PVP治疗,T1椎体因患者不能继续耐受而放弃。T3椎体PKP时间57 min,骨水泥填充量1.9 ml,T2椎体PVP时间49 min,骨水泥填充量1.5 ml。T2椎体左侧椎弓根破坏骨水泥外漏但无临床症状,无其它并发症发生。患者术后5 d出院。术前、术后2 d和3个月随访时VAS评分分别为10分、3分和6分,使用镇痛药物可控制疼痛。[结论]单侧椎弓根外入路PVP和PKP是治疗高位胸椎转移性肿瘤的安全有效方法,能够有效缓解疼痛。
[Objective] To investigate the feasibility and safety of unilateral pedicle external approach percutaneous vertebroplasty (PVP) and percuta-neous kyphoplasty (PKP) in treating vertebral destruction in high-grade thoracic metastatic tumors Sex, evaluation of clinical efficacy. [Method] In March 2008, 1 patient had T1 ~ 3 lung cancer metastasis, male, 59 years old, diagnosed lung cancer for 8 months, severe pain on upper thoracic vertebrae and left shoulder for 6 months, poor analgetic effect and no operation . Local PVP and PKP kits were used to complete the T2 and T3 vertebral body augmentation with local anesthesia under fluoroscopy-guided unilateral pedicle approach. Follow-up observation of the therapeutic effect. [Results] The procedure was successful. The patients with T3 and T2 vertebral body were treated with PKP and PVP respectively. The T1 vertebral body was abandoned because the patient could not continue to tolerate. The PKP time of T3 vertebrae was 57 min, the amount of bone cement was 1.9 ml, the PVP time of T2 vertebrae was 49 min, and the amount of bone cement was 1.5 ml. The left pedicle of the vertebral body of vertebra destroys the leakage of bone cement without any clinical symptoms and no other complications occur. The patient was discharged 5 days after operation. VAS scores at preoperative, 2-day, and 3-month postoperative follow-up were 10, 3, and 6, respectively, and analgesics were used to control pain. [Conclusion] PVP and PKP of unilateral pedicle lateral approach are safe and effective in treating high metastatic thoracic tumors and can effectively relieve pain.