论文部分内容阅读
目的探讨经皮椎体后凸成形术(PKP)治疗胸腰段骨髓瘤引起的椎体压缩性骨折的患者疼痛及日常活动改善情况。方法选择2010年9月~2012年10月28例胸腰段骨髓瘤患者,其中男性21例,女性7例;年龄52~72岁,平均年龄61.2岁;病程6~20个月,平均病程10.6个月。均采用在C型臂下行椎弓根穿刺球囊扩张椎体后注射骨水泥治疗,采用疼痛视觉模拟评分(VAS)、活动能力评分(KPS)于术后24 h、1个月、12个月评估疼痛缓解及日常活动功能恢复情况。结果 28例患者术后24 h内疼痛均缓解,无一例出现脊髓或神经根损伤及压迫症状,复查X射线片见椎体内骨水泥填充良好。手术前后VAS差异有统计学意义(P<0.05);术后随访12个月疼痛缓解及日常活动功能改善趋于稳定;术后24 h、1个月、12个月疼痛缓解率分别为75.00%(21/28)、92.86%(26/28)及82.14%(23/28);所有病例未见椎体进一步压缩、疼痛无明显加重等并发症发生。结论 PKP治疗脊柱胸腰段多发性骨髓瘤具有微创、手术时间短、止痛效果好等优点,是一种安全、有效的手术方式,可以恢复椎体高度,加强椎体强度,重建脊柱稳定性,提高患者生活质量,值得临床推广应用。
Objective To investigate the percutaneous kyphoplasty (PKP) in the treatment of thoracolumbar myeloma caused by vertebral compression fractures in patients with pain and daily activities to improve the situation. Methods Thirty-eight patients with thoracolumbar myeloma from September 2010 to October 2012 were selected, including 21 males and 7 females, aged from 52 to 72 years with a mean age of 61.2 years. The course of disease ranged from 6 to 20 months with an average duration of 10.6 Months. All the patients were treated with descending pedicle of C-arm and balloon-inflated vertebral body. The patients were treated with VAS and KPS at 24 h, 1 month and 12 months after operation Assessment of pain relief and daily functional recovery. Results All the 28 patients were relieved of pain within 24 h postoperatively. None of them showed spinal cord or nerve root injury and compression symptoms. The X-ray film showed good filling of the vertebral bone cement. The VAS difference was statistically significant before and after surgery (P <0.05). Pain relief and improvement of daily activities tended to be stable after 12 months of follow-up. The pain relief rates at 24 h, 1 month and 12 months after operation were 75.00% (21/28), 92.86% (26/28) and 82.14% (23/28) respectively. No complications such as further compression of the vertebral body and no obvious pain were found in all cases. Conclusions PKP is a safe and effective surgical method to treat thoracolumbar multiple myeloma with minimal invasiveness, short operative time and good analgesic effect. It can restore the vertebral height, strengthen the vertebral body and reconstruct the spinal stability , Improve the quality of life of patients, it is worth clinical promotion and application.