Treatment of high thoracic spine with metastasis by one side extrapedicular approach of percutaneous vertebroplasty and kyphoplasty
- VernacularTitle:单侧椎弓根外入路经皮椎体成形和后凸成形术治疗高位胸椎转移性肿瘤
- Author:
Jian WANG
;
Yue ZHOU
;
Chao CHEN
- Publication Type:Journal Article
- Keywords:
percutaneous kyphoplasty;
percutaneous vertebroplasty;
thoracic vertebra;
metastsis
- From:
Orthopedic Journal of China
2006;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To explore the feasibility and safety of percutaneous kyphoplasty(PKP) and percutaneous vertebroplasty(PVP) treating osteolytic lesions of high thoracic vertebra with metastasis by one side extrapedicular approach,and to assess the clinical result of minimally invasive technique. [Methods]In March 2008,one patient(male,59 years old) with T1~3 vertebral metastases of lung cancer diagnozed 8 months ago was selected.The symptoms included extremely severe pain in upper thoracic spine and left should.The analgesic effect was limited for more than 6 months.There was no operative option.Domestic PKP and PVP tool systems were used in local anaesthesia.Under fluoroscopic guidance,T2 and T3 vertebral augmentation were separately completed by single side extrapedicular approach PKP and PVP.Clinical results were followed up and observed.[Results]The procedure was performed smoothly.T3 and T2 vertebrae were differently treated by PKP and PVP.T1 received no treatment because of patient`s intolerance.The operative time of T3 vertebral PKP was 57 minutes.The volume of injected bone cement was 1.9ml.The operative time of T2 vertebral PVP was 49 minutes.The volume of injected bone cement was 1.5ml.Extravertebral leakage of the polymethylmethacrylate(PMMA) into the paravertebral itssue was found without clinical symptom,because osteolysis occurred in the left pedicle of T2 vertebra.There was no other complication.The patient was discharged 5 days after operation.The preoperative,2 days and 3 months postoperative follow-up VAS scores were 10,3 and 6.The patient's markedly pain could be controlled by analgesia.[Conclusion]One side approach percutaneous kyphoplasty is a safe and effective technique for treatment of high thoracic vertebral metastasis with markedly relief of pain.
