Clinical Application of CT-guided Percutaneous Pediculoplasty for Treatment of Vertebral Pedicular Osteolytic Metastases / 实用放射学杂志

ABSTRACT

Objective To explore the methods and clinical application of percutaneous pediculoplasty in the treatment of vertebral pedicular osteolytic metastases.Methods Percutaneous pediculoplasty was performed in 18 patients with (23 Vertebral pedicles ) osteolytic metastases,3 cases localized in thoracic vertebral pedicles and 15 cases in lumbar vertebral pedicles,and two vertebral pedicles involved in 5 cases . Under Multislice helical CT guidance ,2.5～5ml of polymethylmethacrylate ( PMMA ) mixture (ratio of polymer,moner,ultrafluid iodinated oil was 20g10ml3ml) was injected into pathologic pedicles in step by step after successful puncture using 11-13G needles. All cases had been followed for 1～18 months.Results All cases were successful punctured. Pain relieved in all cases after percutaneous pediculoplasty.7 cases had cement leakage,among them,cement leaked into tumor tissue in 5 cases(2 cases with leakage into intervertebral foremen),nerve radicular pain occurred in one case,the pain disappeared 3 days later after intravenous mannitol and lower dose dexamethasone drips;the cement leaked into vertebral canal a little without clinical symptom in one case.Conclusion CT-guided percutaneous pediculoplasty is a minimally effective and safe method for osteolytic vertebral pedicular metastases in treatment of pain and enhancement of spinal stability.