Qingshan Liu, Yuanliang He, Xi Lei, Jun Yan, Wei Feng, Chengchui He, Xuemei Huang, Dan Cao, Yingchun Dong, Dingding Li
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Outcome evaluation frequently employs the visual analog scale (VAS) and the Oswestry disability index (ODI) in assessing spinal surgery outcomes.</p><p><strong>Methods: </strong>A retrospective analysis included 111 patients treated between January 2014 and January 2018 in our hospital. Patients were categorized into 2 groups: MCP group (n=51) and PVP group (n=60). Grades based on the percentage of posterior wall defect area were established: grade I (≤25%), grade II (26% to 50%), grade III (51% to 75%), and grade IV (76% to 100%). Efficacy was assessed using VAS and ODI.</p><p><strong>Results: </strong>Both MCP and PVP groups exhibited significant pain relief and improved motor function. No significant differences were observed in VAS and ODI scores at any follow-up point ( P >0.05). In the MCP group, bone cement leakage occurred in 13 cases, with a leakage rate of 25.49%. However, none of the patients experienced clinical or neurological symptoms. In the PVP group, bone cement leakage occurred in 50% of patients, with 6 patients developing neurological symptoms. Significant differences between the groups were observed in major complications related to bone cement leakage ( P =0.03).</p><p><strong>Conclusion: </strong>MCP demonstrates efficacy in pain relief and safety in treating vertebral metastases with deficient posterior walls. 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引用次数: 0
摘要
研究设计：对溶骨性椎体转移瘤的网状容器成形术（MCP）进行回顾性研究：本研究旨在评估MCP治疗伴有后壁缺损的晚期椎体转移瘤的有效性和安全性：背景：椎体转移瘤的诊断通常依赖于患者的肿瘤病史、骨扫描或椎体磁共振成像。手术治疗通常需要对椎体组织取样进行病理诊断。修订版德桥评分通常用于预测骨转移患者的生存时间。脊柱手术的结果评估通常采用视觉模拟量表（VAS）和Oswestry残疾指数（ODI）：回顾性分析纳入了2014年1月至2018年1月期间在我院接受治疗的111名患者。患者分为两组：MCP组（n=51）和PVP组（n=60）。根据后壁缺损面积百分比进行分级：I级（≤25%）、II级（26%至50%）、III级（51%至75%）和IV级（76%至100%）。疗效采用 VAS 和 ODI 进行评估：结果：MCP 和 PVP 组均能明显缓解疼痛并改善运动功能。任何随访点的 VAS 和 ODI 评分均无明显差异（P>0.05）。MCP 组有 13 例发生骨水泥渗漏，渗漏率为 25.49%。但是，没有一名患者出现临床或神经症状。在PVP组中，50%的患者出现骨水泥渗漏，其中6名患者出现神经症状。在与骨水泥渗漏相关的主要并发症方面，两组之间存在显著差异（P=0.03）：结论：在治疗后壁缺损的椎体转移瘤时，MCP具有止痛效果和安全性。对于脊柱外科医生治疗后壁缺损的椎体转移瘤来说，MCP是一种很有前景的选择。
Container Plasty in Advanced Painful Osteolytic Vertebral Metastases With Posterior Wall Defect: A Retrospective Observational Study.
Study design: Review of mesh-container plasty (MCP) in osteolytic vertebral metastases.
Objective: This study aims to assess the efficacy and safety of MCP in treating advanced vertebral metastases with posterior wall defects.
Background: Diagnosis of vertebral metastases typically relies on the patient's tumor history, bone scans, or vertebral MRI. Surgical intervention often involves sampling vertebral body tissue for pathologic diagnosis. The revised Tokuhashi score is commonly used to predict survival time in patients with bone metastases. Outcome evaluation frequently employs the visual analog scale (VAS) and the Oswestry disability index (ODI) in assessing spinal surgery outcomes.
Methods: A retrospective analysis included 111 patients treated between January 2014 and January 2018 in our hospital. Patients were categorized into 2 groups: MCP group (n=51) and PVP group (n=60). Grades based on the percentage of posterior wall defect area were established: grade I (≤25%), grade II (26% to 50%), grade III (51% to 75%), and grade IV (76% to 100%). Efficacy was assessed using VAS and ODI.
Results: Both MCP and PVP groups exhibited significant pain relief and improved motor function. No significant differences were observed in VAS and ODI scores at any follow-up point ( P >0.05). In the MCP group, bone cement leakage occurred in 13 cases, with a leakage rate of 25.49%. However, none of the patients experienced clinical or neurological symptoms. In the PVP group, bone cement leakage occurred in 50% of patients, with 6 patients developing neurological symptoms. Significant differences between the groups were observed in major complications related to bone cement leakage ( P =0.03).
Conclusion: MCP demonstrates efficacy in pain relief and safety in treating vertebral metastases with deficient posterior walls. It represents a promising option for spinal surgeons managing vertebral metastases with posterior wall deficiencies.
期刊介绍：
Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure.
Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
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