Abstract

Purpose

To retrospectively evaluate the efficacy and safety of computed tomography (CT)-guided microwave ablation (MWA) combined with percutaneous vertebroplasty (PVP) as a treatment for painful high thoracic vertebral metastases (T1–T4).

Materials and Methods

In this retrospective study, 23 adult patients (33 high thoracic vertebral metastases) with moderate to severe pain were treated with CT-guided MWA and PVP. The procedural effectiveness was evaluated using a Visual Analog Scale (VAS), daily morphine consumption, and the Oswestry Disability Index (ODI) before and immediately after the procedure and during follow-up.

Results

Technical success was achieved in all patients. The mean pre-procedure VAS score and morphine doses were 6.7 ± 1.7 (5–10) and 105.2 ± 32.7 (30–150) mg, respectively. The mean VAS scores and daily morphine doses at 24 h and 1, 4, 12, and 24 weeks post-operatively were 3.2 ± 1.4 and 41.3 ± 9.6 mg; 1.8 ± 1.0 and 31.5 ± 12.2 mg; 1.4 ± 1.3 and 19.6 ± 12.4 mg; 1.1 ± 0.8 and 14.5 ± 9.6 mg; and 1.0 ± 0.7 and 13.9 ± 9.3 mg, respectively (all p < 0.001). ODI scores significantly decreased (p < 0.05). Minor cement leakage occurred in 10 patients (30.30%) with no symptoms. Follow-up imaging showed no local tumor progression.

Conclusions

Preliminary results suggest MWA combined with PVP is an effective and safe treatment for painful high thoracic vertebral metastases (T1–T4) and can significantly relieve pain and improve the quality of life of patients. However, its efficacy should be confirmed by mid- and long-term studies.

中文翻译：

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计算机断层扫描引导微波消融联合经皮椎体成形术治疗疼痛性高位胸椎转移瘤

摘要

目的

回顾性评估计算机断层扫描 (CT) 引导的微波消融 (MWA) 联合经皮椎体成形术 (PVP) 作为治疗疼痛性高位胸椎转移瘤 (T1-T4) 的疗效和安全性。

材料和方法

在这项回顾性研究中，23 名中度至重度疼痛的成年患者（33 名高位胸椎转移瘤）接受了 CT 引导的 MWA 和 PVP 治疗。使用视觉模拟量表 (VAS)、每日吗啡消耗量和 Oswestry 残疾指数 (ODI) 在手术前后和随访期间评估手术效果。

结果

所有患者均取得了技术上的成功。平均术前 VAS 评分和吗啡剂量分别为 6.7 ± 1.7 (5–10) 和 105.2 ± 32.7 (30–150) mg。术后 24 小时和 1、4、12 和 24 周的平均 VAS 评分和每日吗啡剂量分别为 3.2 ± 1.4 和 41.3 ± 9.6 mg；1.8 ± 1.0 和 31.5 ± 12.2 毫克；1.4 ± 1.3 和 19.6 ± 12.4 毫克；1.1 ± 0.8 和 14.5 ± 9.6 毫克；和 1.0 ± 0.7 和 13.9 ± 9.3 毫克，分别（所有p  < 0.001）。ODI 分数显着降低（p  < 0.05）。10 名患者（30.30%）发生轻微骨水泥渗漏，无症状。后续成像显示没有局部肿瘤进展。

结论

初步结果表明，MWA 联合 PVP 是治疗疼痛性高位胸椎转移瘤（T1-T4）的有效且安全的方法，可显着减轻患者的疼痛，提高患者的生活质量。但其疗效尚需中长期研究证实。