髋臼转移瘤经皮螺钉骨水泥成形的早期结果

Early consequences of percutaneous screw and bone cement osteoplasty for periacetabular metastases

摘要:

[目的] 探讨经皮中空螺钉结合骨水泥成形技术治疗髋臼周围转移瘤的早期临床结果。[方法] 回顾性分析2020 年5 月—2022 年6 月本院治疗髋臼周围转移瘤36 例患者的临床资料，根据医患沟通结果，其中16 例采用经皮螺钉结合骨水泥成形技术（复合组），20 例单纯经皮骨水泥成形术（单纯组）。比较两组临床及影像结果。[结果] 复合组的手术时间[(70.4±7.4)min vs (39.8±7.2) min, P＜0.05]、透视次数[(23.1±5.7) 次vs (13.3±5.1) 次, P＜0.05] 显著多于单纯组（P＜0.05），而两组骨水泥注入量、术后下地时间的差异无统计学意义（P＞0.05）。随访时间平均（10.4±2.5） 个月。术后随时间推移，两组患者VAS 评分、Har-ris 评分、SF-36 评分均显著改善（P＜0.05），术前两组上述指标的差异均无统计学意义（P＞0.05），复合组VAS 评分术后1 周[(2.4±0.6) vs (3.3±1.2), P＜0.05]、术后3 个月[(2.1±1.2) vs (3.2±1.6), P＜0.05] 显著优于单纯组，但两组Harris 评分、SF-36 评分的差异无统计学意义（P＞0.05）。影像方面，与术前相比，术后两组病理骨折及病灶大小情况无显著变化（P＞0.05），相应时间点，两组间上述影像指标的变化差异均无统计学意义（P＞0.05）。[结论] 经皮中空螺钉结合骨水泥成形技术治疗髋臼周围转移瘤能够有效缓解疼痛，改善髋关节功能，提高患者生活质量。

Abstract:

[Objective] To evaluate the early clinical results of percutaneous cannulated screw and bone cement osteoplasty for periace-tabular metastases. [Methods] A retrospective study was performed on 36 patients who received surgical treatment for periacetabular metas-tases in our hospital from May 2020 to June 2022. According to doctor-patient communication, 16 patients were treated with percutaneousscrew combined with bone cement osteoplasty (the combined group), while the remaining 20 patients were treated with simple percutaneousbone cement osteoplasty (the simple group). Clinical and imaging data were compared between the two groups. [Results] Although the com-bined group was significantly greater than the simple group in terms of operation time [(70.4±7.4) min vs (39.8±7.2) min, P＜0.05], fluorosco-py times [(23.1±5.7) times vs (13.3±5.1) times, P＜0.05], there was no significant difference in terms of the amount of bone cement injectedand postoperative ambulation time (P＞0.05). With time of the follow-up lasted for (10.4±2.5) months on a mean, the VAS, Harris and SF-36scores significantly improved in both groups (P＜0.05), which was not statistically significant between the two groups before surgery (P＞0.05).However, the combined group was significantly superior to the simple group in terms of VAS score 1 week postoperatively [(2.4± 0.6) vs (3.3 ±1.2), P＜0.05], 3 months postoperatively [(2.1±1.2) vs (3.2±1.6), P＜0.05], despite of the fact that there was no significant difference in Harrisscore and SF-36 score between the two groups (P＞0.05). Regarding imaging, the pathological fracture and lesion size remained unchangedin both groups postoperatively compared with those the preoperatively (P＞0.05), which were not of significant differences between the twogroups at any time points accordingly (P＞0.05). [Conclusion] Percutaneous hollow screw combined with bone cement in the treatment ofperiacetabular metastases can effectively relieve pain, improve hip function and improve patients' quality of life.