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首页> 外文期刊>British journal of neurosurgery >Comparison of subtotal vertebral resection with reconstruction and percutaneous vertebroplasty for treatment of metastasis in the lumbar spine
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Comparison of subtotal vertebral resection with reconstruction and percutaneous vertebroplasty for treatment of metastasis in the lumbar spine

机译：细胞椎体切除重建和经皮椎成形术比较治疗腰椎转移的椎体成形术

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Purpose:Tumor metastasis in the spine can cause pain and fractures, leading to deformities, and deficits in movement, sensation, and bowel/bladder function. Percutaneous vertebroplasty (PVP) and subtotal vertebral resection with reconstruction (SVR) are suitable treatments, but their relative clinical efficacy is uncertain. The purpose of this retrospective cohort study was to compare the management and clinical effect of SVR for lumbar metastatic tumor with PVP. Methods:Sixty-seven patients (mean age: 58.6 years) with metastases in the lumbar spine received SVR or PVP at our institution between 2010 and 2013. Thirty-three patients received SVR via a posterior approach, in which vertebrae were resected, with the anterior and lateral walls retained using polymethylmethacrylate (PMMA), followed by reconstruction and pedicle screw fixation. Thirty-four patients received PVP via the vertebral pedicle. Patients were followed for 3-26 months. Results:None of the patients experienced serious complications after surgery, and all patients experienced significant amelioration of pain. Twelve patients (8 in the PVP group and 4 in the SVR group) died during the follow-up, and the survival time was significantly longer in the SVR group. Two patients in the SVR group and 7 patients in the PVP groups experienced recurrence during follow-up, but the groups had no significant difference in local recurrence. Both treatments significantly reduced scores for pain on a visual analog scale (pain-VAS) and disability (Oswestry Disability Index [ODI]), and increased performance status (Karnofsky Performance Status [KPS]). Compared with the PVP group, the SVR group had better ODI score at 1 month and 3 months after surgery and a higher KPS score at 1 month after surgery. The two groups had no significant difference in pain-VAS scores during follow-up. Conclusions:SVR is a reliable treatment for lumbar metastatic tumor and provides good survival rate and satisfying follow-up results.
机译：目的：脊柱中的肿瘤转移会导致疼痛和骨折，导致畸形，以及运动，感觉和肠道/膀胱功能的缺陷。经皮椎成形术（PVP）和重建（SVR）的椎骨切除（SVR）是合适的治疗方法，但它们的相对临床疗效是不确定的。该回顾性队列队列研究的目的是将SVR与PVP进行腰部转移肿瘤的管理和临床影响。方法：六十七名患者（平均年龄：58.6岁）在2010年至2011年间，在我们的机构接受了腰椎转移的腰椎或PVP。三十三名患者通过后期接受SVR，其中椎骨被切除，其中使用聚甲基丙烯酸甲酯（PMMA）保持的前侧壁，然后重建和椎弓根螺钉固定。三十四名患者通过椎椎弓根接受PVP。患者遵循3-26个月。结果：患者没有患者在手术后经历过严重的并发症，所有患者的疼痛都会显着改善。在随访期间，12名患者（SVR组中的4个中的8例和4中的4个患者）死亡，SVR组的存活时间明显更长。两名患者在SVR组和7例PVP组患者在随访期间经历复发，但本组局部复发没有显着差异。两种治疗在视觉模拟规模（疼痛-Vas）和残疾（Oswestry残疾指数[ODI]）和绩效状况增加（Karnofsky性能状态[KPS]）上显着降低了疼痛的分数。与PVP组相比，SVR组在手术后1个月和3个月内具有更好的odi得分，手术后1个月越高。随访期间，两组在痛苦中没有显着差异。结论：SVR是腰椎转移性肿瘤的可靠治疗，提供良好的存活率和满足后续结果。

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