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Surgical treatment of 21 patients with spinal metastases of differentiated thyroid cancer

Chinese Medical Journal 2014年第23期127卷 4092-4096页

作者： Jiang Liang Ouyang Hanqiang Liu Xiaoguang Wei Feng Wu Fengliang Dang Lei Liu Zhongjun Department of Orthopaedics Peking University Third Hospital Beijing 100191 China Peking University Health Science Center Peking University Beijing 100191 China

Background Differentiated thyroid cancer （DTC） is a common primary cancer for spinal metastases （SM）.The treatments for DTC spinal metastases （SM） have evolved from simple surgery and radiotherapy to a multidisciplinary comprehensive therapeutic strategy of combined spinal surgery,general surgery,radiotherapy,nuclear medicine and *** purpose of this study was to discuss the efficacy and prognosis associated with different surgical treatments of SM patients with *** A total of 21 consecutive patients with SM of DTC that were treated between 1999 and 2013 were *** was routinely performed to achieve the pathological diagnosis before *** patients underwent total spondylectomy intralesionally or piecemeally,and 18 had *** recurrence and survival times were analyzed by the Kaplan-Meier *** Nineteen patients （90％） had an average of 42.7 months （range,7-170 months） *** median visual analogue scale for pain reduced from 5 points to 1 point （P ＜0.01）,and the median Karnofsky performance score increased from 70 to 90 points after surgery （P ＜0.01）.Seventeen patients with neurological deficits attained improvements after surgeries,of at least one level according to the Frankel classification （P ＜0.01）.Eight patients with curettage had *** patients died of DTC,12 patients lived with disease,and three patients were *** significant effects on postoperative recurrence or survival were observed between surgery combined with conservative treatment,total spondylectomy,the number of bone metastases and visceral *** DTC-SM have a relatively favorable prognosis,and curettage and stabilization can effectively relieve the pain and improve the quality of life and neurological status of the *** patients with Tomita scores of ＜3,total spondylectomy may have better clinical *** therapeutic strategies including surgery,radioiodine,external

关键词： spinal metastases thyroid cancer surgery survival

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Percutaneous transforaminal endoscopic decompression combined with percutaneous vertebroplasty in treatment of lumbar vertebral body metastases:A case report

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World Journal of Clinical Cases 2022年第22期10卷 7944-7949页

作者： Qiang Ran Tong Li Zhi-Ping Kuang Xiao-Hong Guo Department of Orthopaedics Chongqing Hospital of Traditional Chinese MedicineChongqing 400010China Hospital of Chengdu University of Traditional Chinese Medicine Chengdu 610000Sichuan ProvinceChina Department of Orthopaedics Chongqing Hospital of Traditional Chinese MedicineChongqing 400000China Department of Pharmacy Chongqing Hospital of Traditional Chinese MedicineChongqing 400000China

BACKGROUND Percutaneous endoscopic lumbar discectomy(PTED)is a procedure that is commonly used to treat lumbar disc herniation and spinal *** its less invasiveness,this surgery is rarely used to treat spinal *** vertebroplasty(PVP)has been utilized to treat lumbar vertebral body metastases but it has not proven useful in treating sciatic *** SUMMARY A 68-year-old woman presented with low back pain and radicular *** couldn't straighten her legs because of severe *** tomography(CT)showed a mass lesion in the lung and bone destruction in the L4 *** biopsy of the lung lesion revealed adenocarcinoma and the biopsy for L4 vertebrae revealed metastatic *** paired with PVP was performed on the patient due to the patient's poor overall physical state and short survival *** arterial embolization of vertebral tumors was performed before surgical resection to reduce excessive blood loss during the *** incision was scaled up with the TESSY *** pain was obviously relieved following the operation and no serious complications *** CT showed that the decompression around the nerve root was successful,polymethyl methacrylate filling was satisfactory and the tumor tissue around the nerve root was obviously *** the 1-year follow-up period,the patient was in a stable *** PTED in combination with PVP is an effective and safe treatment for Lumbar single-level spinal Column metastases with radicular *** of the small sample size and short followup time,the long-term clinical efficacy of this method needs to be further confirmed.

关键词： Minimally invasive surgery Nerve root Percutaneous spinal metastases Transforaminal endoscopic decompression Case report

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Kyphoplasty versus vertebroplasty for the treatment of malignant vertebral compression fractures caused by metastases： a retrospective study

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Chinese Medical Journal 2014年第8期127卷 1493-1496页

作者： Li Zhi Ni Caifang Chen Long Sun Zhiyong Yang Chao Zhao Xin Wang Yanwei Department of Interventional Radiology the First Affiliated Hospital of Soochow University Suzhou Jiangsu 215006 China Department of Orthopaedic Surgery the First Affiliated Hospital of Soochow University Suzhou Jiangsu 215006 China Department of General Surgery the First Affiliated Hospital of Soochow University Suzhou Jiangsu 215006 China

Background There are few comparative studies regarding kyphoplasty （KP） and vertebroplasty （VP） for the treatment of painful vertebral compression fractures （VCF） in patients with cancer. The purpose of this study is to retrospectively compare KP with VP in pain improvement, cement leakage incidence, and the cost of treatment of malignant VCE Methods We performed a retrospective study of clinical data for 80 patients with multiple spinal metastases, treated with KP in 42 cases and VP in 38. Visual analog scale （VAS） scores were collected pre-operatively, post-operatively, at 1 month, 6 months, and 1 year after treatment. Cement leakage was identified using fluoroscopy and CT scan. Total cost per patient was also collected. Results There was a significant difference between the pre- and post-operative VAS scores （7.4＋2.0 to 3.8＋1.6, P 〈0.001 in the KP group; 6.7＋2.4 to 3.7＋1.4, P 〈0.001 in the VP group）, and was maintained at 1-year follow-up （3.2＋1.4 in the KP group, 3.1＋1.3 in the VP group）. However, the difference in VAS score between these two groups was insignificant at baseline and every follow-up assessment post-operatively （P 〉0.05）. The incidence of cement leakage in the KP group was lower than that of the VP group （16.9% （14/83） vs 30.3% （23/76）, P 〈0.05）. However, none of the patients developed any symptoms. The length of postoperative hospital stay in the VP group was shorter than that of the KP group （（2.4＋1.3） vs （5.3＋1.9） days, P 〈0.05）. Total hospital cost in the KP group was much higher than that of the VP group （RMB Yuan 8 492_＋3 332 vs RMB Yuan 3 173~1 341, P〈0.01）. Conclusions VP and KP are both effective in providing pain relief for patients with cancer-related VCF. KP provides no greater degree of pain improvement. KP is associated with a lower rate of cement leakage compared with VP. VP is associated with lower cost and shorter postoperative hospital stay in China.

关键词： spinal metastases vertebral compression fractures kyphoplasty vertebroplasty

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