摘要
Abstract
Objective To evaluate the efficacy and safety of percutaneous vertebroplasty(PVP)com-bined with bone-filling mesh containers(BFMCs)in treating spinal metastases with posterior vertebral wall breach.Methods Between December 2022 and May 2024,a total of 48 patients with osteolytic spinal me-tastases involving 51 vertebrae underwent either conventional PVP or PVP combined with BFMCs.Among them,25 patients(26 vertebrae)in Group A received conventional PVP,while 23 patients(25 vertebrae)in Group B underwent PVP combined with BFMCs.A comparison was made between the two groups regarding the volume of bone cement injected,the postoperative increase in vertebral height,the loss of vertebral height at one year post operatively,the improvement rate in 24-hour and 3-month postoperative pain visual analogue scale(VAS),and the bone cement leakage rate.Results In Group A,the intraoperative bone cement injection volume was(3.7±0.3)mL,the improvement rate in 24-hour postoperative VAS was 73％±5％,and the 3-month postoperative improvement rate was 60％±7％.In Group B,the intraoperative bone cement injection vol-ume was(3.4±0.8)mL,the improvement rate of 24-hour postoperative VAS was 71％±7％,and the 3-month postoperative VAS improvement rate was 62％±4％.There was no difference between the two groups(P＞0.05).The postoperative increase in vertebral height was(3.9±2.5)mm in Group A,with a loss of one-year postoperative vertebral height of(2.0±0.4)mm.In Group B,the postoperative increase in vertebral height was(7.4±2.1)mum,with a loss of one-year postoperative vertebral height of(1.1±0.6)mum.There were significant differences between the two groups(P＜0.05).In Group A,bone cement leakage occurred in 6 vertebrae(23.1％),in which one in the intervertebral space,two in the paravertebral region,and three at the posterior vertebral edge.In Group B,bone cement leakage occurred only in one vertebra(4％),which was in the paravertebral region.There was no difference between the two groups(P＞0.05),and none of the leakage cases in either group resulted in neurological compression symptoms.Conclusions PVP combined with BFMCs is an effective and safe treatment for spinal metastases with posterior vertebral wall breach.Compared to conventional PVP,it achieves comparable pain relief with the same cement volume while providing superior vertebral height restoration and long-term maintenance,along with a low risk of cement leakage.关键词
经皮椎体成形术/脊柱转移瘤/骨填充网袋Key words
percutaneous vertebroplasty/spinal metastases/bone-filling mesh containers
