članak: 1 od 1  
Acta chirurgica iugoslavica
2009, vol. 56, br. 4, str. 153-158
jezik rada: engleski
stručni članak
doi:10.2298/ACI0904153B
Kontrola bolnih lezija kičme prouzrokovanih multiplim mielomom primenom perkutano aplikovanog akrilnog cementa
Bošnjaković P.a, Ristić S.a, Mrvić M.a, Miljković A.E.b, Vukićević T.b, Marjanović G.b, Mačukanović-Golubović L.b
aInstitute of Radiology, Clinical Center, Niš
bClinic for haemathology, Clinical Center, Niš

Sažetak

Podaci i cilj rada: spinalne lezije sa izraženom destrukcijom kosti su česta lokacija u bolesnika sa multiplim mielomom što dovodi do ozbiljnih kliničkih simptoma. Cilj ove studije je evaluacija terapijskog efekta perkutane vertebroplastike (PVP) u tretmanu lezija pršljenskih tela u bolesnika obolelih od multiplog mieloma. Bolesnici i metode: Dvadeset devet bolesnika (55 pršljenskih tela) tretirano je nakon kompletne dijagnostičke obrade, pripreme i obezbeđenja pristanka na intervenciju. Pozicioniranje igle i ubrizgavanje akrilatnog cementa vršeno je pod kontrolom fluoroskopije. Rezultati: Prosečna vrednost vizuelno analognog skora smanjena je sa 7,8 pre na 2,3 posle intervencije. Curenje cementa u meka tkiva bilo je prisutno na 9 tretiranih nivoa, manje epiduralne količine cementa na 5, pojava cementa u perivertebralnim venama u 4 te u intervertebral nim diskusima u 3 nivoa bez kliničkih manifestacija. Efekti PVP su bili stabilni u periodu praćenja od 12 meseci. Subjektivna procena ishoda intervencije pokazala je poboljšanje od 1,45 (bol), 1.15 (pokretljivost) i 1,23 (korišćeni lekovi). Bol u leđima se ponovo javio u 9 bolesnika usled pojave novih lezija na nivoima koji nisu tretirani. Zaključak: U našoj seriji, PVP bolnih lezija uzrokovanih multiplim mielomom obezbedila je neposredno i dugotrajno obezboljavanje. Procedura je sigurna a, uprkos prisutnog curenja cementa, može biti izvođena u ambulantnih bolesnika.

Ključne reči

perkutana vertebroplastika; bol u leđima; multipli mijelom

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