spine,脊柱.pdf

R E V I E W Minimally Invasive Treatments for Spinal Metastases: Vertebroplasty, Kyphoplasty, and Radiofrequency Ablation Ryan J. Halpin, BS, Bernard R. Bendok, MD, and John C. Liu, MD etastatic tumors are the most common malignancy of bone, affecting 10%– Abstract Bony metastases are the most common tumors affecting the 30% of all cancer patients [1, 2]. The musculoskeletal system. The most common site of such metastases is M vertebral column is the most common the spinal column. Many patients with these tumors present with pain site of such metastases, spinal metastases being and pathologic fractures. Three relatively new, minimally invasive treat- found in 36% of patients who have died of neo- ments may be used to provide supportive care in this patient population: plastic disease [3]. Spinal metastases are estimated vertebroplasty, kyphoplasty, and radiofrequency ablation. In this report, to be present in 5%–33% of all cancer patients at we review the literature for each of these procedures and discuss their some time during the course of their disease [4, indications, results, and complications. 5]. Tumors that commonly metastasize to bone include prostate, breast, lung, kidney, and thyroid cancers, which account for 80% of skeletal metas- hospitalizations and all-cause mortality [9, 10]. Mr. Halpin is a medical tases [2, 3, 6]. Five-year survival after the diagno- Deformities also may occur, such as scoliosis due student at Northwestern sis of a skeletal metastatic lesion ranges from 2% to paraspinal muscle spasm and kyphosis due to University Feinberg