ABSTRACT
Objective To analyze the clinical characteristics of patients with metastatic carcinoma of bone. Methods The clinical data of 217 patients with metastatic carcinoma of bone was retrospectively analyzed. The clinical features were summarized,including primary tumor,age distribution,first symptom,time of onset and bone metastatic site. Visual analogue scale(VAS)was used to evaluate the difference of pain in patients with bone metastases before and after zoledronic acid treatment. Results The bone metastasis occurred more frequently in men(male:female = 1.28:1). The majority of primary tumors were lung cancer(51.61％)and breast cancer (15.67％),respectively. The peak ages of the patients with metastatic carcinoma of bone were between 50 and 70 years old. Most of the patients with metastatic carcinoma of bone initially showed varying degrees of pain ,some of the patients with dysfunction,pathological fracture,or local lumps as the initial symptoms,only a tiny minority of patients were inadvertently found. Onset time was often within 3 months ,which accountings for 54.84％. Bone metastases were mostly in the spine,pelvis,femur and ribs,and most of the bone metastases were multiple. The VAS score of 108 patients who with bone metastases pain treated by zoledronic acid was 0～4(1.31 ± 1.07),with statistically significant differences compared with pretherapy(P<0.01). Conclusion In order to reduce the pain of patients,and to improve the quality of life and prolong the survival time,bone metastases should be diagnosed early and given comprehensive treatment.
ABSTRACT
Objective To analyze the clinical characteristics of patients with metastatic carcinoma of bone. Methods The clinical data of 217 patients with metastatic carcinoma of bone was retrospectively analyzed. The clinical features were summarized,including primary tumor,age distribution,first symptom,time of onset and bone metastatic site. Visual analogue scale(VAS)was used to evaluate the difference of pain in patients with bone metastases before and after zoledronic acid treatment. Results The bone metastasis occurred more frequently in men(male:female = 1.28:1). The majority of primary tumors were lung cancer(51.61％)and breast cancer (15.67％),respectively. The peak ages of the patients with metastatic carcinoma of bone were between 50 and 70 years old. Most of the patients with metastatic carcinoma of bone initially showed varying degrees of pain ,some of the patients with dysfunction,pathological fracture,or local lumps as the initial symptoms,only a tiny minority of patients were inadvertently found. Onset time was often within 3 months ,which accountings for 54.84％. Bone metastases were mostly in the spine,pelvis,femur and ribs,and most of the bone metastases were multiple. The VAS score of 108 patients who with bone metastases pain treated by zoledronic acid was 0～4(1.31 ± 1.07),with statistically significant differences compared with pretherapy(P<0.01). Conclusion In order to reduce the pain of patients,and to improve the quality of life and prolong the survival time,bone metastases should be diagnosed early and given comprehensive treatment.
ABSTRACT
Objective To observe the changes of the height of intervertebral discs of the segments adjacent to the fusional and instrumental area after the operation and the relation between the changes of height of intervetebral discs in the adjacent segments and the angle of the pedicle screw.Methods Thirty-one patients who underwent internal fixation from September 2004 to March 2006 were retrospectively analyzed.The intervertebral discs height of adjacent segment was studied.The influence of"Suspensory fixation"on the changes of height of adjacent intervertebral discs was compared.The relation between the changes of the height of the upper adjacent intervertebral discs and the angle of pedicle screw was analyzed.Results The mean follow-up period for the patients was 13.5 months(10-16 months).In the operating-group,the height of the adjacent intervertebral disc decreased slightly,but the changes had no statistical significance(P＞0.05).Between the group fixed between L5 and S1 and group fixed between L4and L5,the changes of the height of the upper adjacent intervertebral discs had no obvious difference(P＞0.05).In the group fixed between L4 and L5,there had no obvious difference between the changes of the height of the upper adjacent intervertebral discs and the changes of the height of the lower one(P＞0.05).When the operating-group were divided into two groups according to the angle of pedicle screw (＜6°or＞6°),the changes of the height of the upper adjacent intervertebral discs had no obvious difference(P＞0.05).But there had positive and correlative relation between changes of the height of the adjacent intervertebral discs and the angle of pedicle screw(r=0.373,P=0.039).Conclusion "Suspensory fixation"has no different influence on the changes of height of adjacent intervertebral discs.There has no difference on the risk of degeneration between upper and lower segment adjacent to the fusional area.There has positive and correlative relation between the changes of height of the upper intervertebral discs adjacent to the fusional area and the angle of pedicle screw,that is,the bigger the angle is,the more clearly the height of adjacent intervertebral discs will change.