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微波原位消融术治疗单节段胸-腰-骶椎体转移瘤的临床疗效评估
于哲, 张明华, 高铜栓, 丁瑞, 范清宇
空军军医大学第二附属医院骨肿瘤科,西安 710038
Evaluation of clinical efficacy of microwave ablation in situ for thoracic, lumbar and sacral spinal metastases
Yu Zhe, Zhang Minghua, Gao Tongshuan, Ding Rui, Fan Qingyu
Department of Orthopedic Surgery, Orthopedics Oncology Institute of Chinese PLA, Tangdu Hospital, Air Force Military Medical University, Xi′an 710038, China
Abstract：Objective To evaluate the clinical outcomes of patients with single spinal metastasis of thoracic, lumbar or sacral vertebra treated with microwave ablation in situ. Methods For 28 patients with single spinal metastasis of thoracic, lumbar or sacral vertebra, detailed and personal surgical plans were carried out. Instead of en bloc resection, hyperthermia ablation in situ was performed followed by strengthening procedures under the guidance of G-arm fluoroscopy machine. Intraoperatively, spinal cord and nerve root were properly protected. The bone defects were reconstructed by bone cement after the diseased lesions were revomed. All patients were followed up for almost 1 year postoperatively. During follow-up, X-ray and MRI images were obtained, and the level of pain and neurologic outcomes were also examined. Results All 28 patients successfully received microwave ablation in situ. The average ablation time was approximately 8 minutes and the average amount of bone cement implanted was approximately 10.5ml. The pain scores of digital pain classification before and 3 months after operation were 7.86±1.58 and 3.07±1.89(P<0.05). The postoperative neurological function of 22 patients was improved than that before operation. No significant changes were observed in 5 patients. The neurological function of the affected limb was relieved, whereas the symptoms of the healthy limb were slightly worse in the remaining case. Conclusions Microwave ablation in situ is a feasible and effective surgical method for single spinal metastasis of thoracic, lumbar or sacral vertebra. It might possess many advantages, such as clear surgical field, smaller incisions, less bleeding, and safe margins during the operations. Further more, it could significantly relieve pain, restrict tumor growth, and improve the quality of life of patients. It is an innovative and distinctive therapeutic alternative for single spinal metastasis, which deserves widespread application.
Yu Zhe,Zhang Minghua,Gao Tongshuan et al. Evaluation of clinical efficacy of microwave ablation in situ for thoracic, lumbar and sacral spinal metastases[J]. Chinese Journal of Radiation Oncology, 2021, 30(3): 253-257.
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2021, Vol. 30 
