Male patient, 64 years old, has experienced severe back pain since March 2022 without obvious causes.
March 23, 2022, chest CT prompts: MT of the right lower lung, accompanied by multiple metastasis of the adjacent ribs, T4, T5 vertebrae and attachments, and pathological fracture of the T5 vertebrae. On March 30, 2022, the pathological results of vertebral biopsy showed that spinal mass metastatic hypodifferentiated adenocarcinoma, tended to metastatic squamous cell carcinoma.
After eleven chemotherapy and eight radiotherapy sessions in a tumor hospital, he went to the Radiation Interventional Department of Luwan Branch of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine for treatment.
On November 14, 2022, percutaneous apnea was performed under DSA-guided "T5 vertebral radiofrequency ablation + percutaneous vertebral puncture". Because the bones of the T5 vertebral body were damaged by the tumor and severe pathological compression fractures occurred, the height of the vertebral body was only 3.62mm, and the diameter of the bone needle was 2mm, so the difficulty of puncture needle operation was extremely high. After successfully setting the needle to the target by bilateral approach of
T5 vertebral metastasis and severe compression fracture
bilateral approach, single-needle radiofrequency ablation was first performed using RITA-1500X radiofrequency instrument and UniBlate-25 radiofrequency needle. The parameters were set: power 35W, target temperature 60 ℃, time 10 Min. After that, a total of about 2ml of bone cement was injected through the double-ingress path. After percutaneous vertebratomy, CT scan was performed, and after reconstruction, the bone cement was filled in place in the T5 vertebra and was well distributed.
rounds twelve hours after surgery, and the patient complained that the pain was relieved by 80%. The patient requires an optional interventional treatment for the T4 vertebrae.
DSA-guided bilateral pedicle ablation successfully (lateral position)
DSA-guided bilateral pedicle ablation successfully (positive position)
Single-needle radiofrequency ablation vertebral tumor (lateral position)
Single-needle radiofrequency ablation vertebral tumor (positive position)
Dual-channel injection The sagittal reconstruction of bone cement was about 2ml
PVP after sagittal reconstruction showed good distribution of bone cement
PVP after coronary reconstruction showed good distribution of bone cement
PVP after axial scanning of PVP after sagittal scanning showed good distribution of bone cement
1
1022 On November 17, 2022, percutaneous puncture was performed under DSA-guided "T4 vertebral radiofrequency ablation + percutaneous vertebroplasty". After the two-sided approach successfully set the needle to the target, the single-needle radio frequency ablation was first performed using the RITA-1500X radio frequency meter and the UniBlate-25 radio frequency needle. The parameters were set: power 35W, target temperature 60 ℃, and time 10 Min. After that, a total of about 10 ml of bone cement was injected through the double-entry route. After percutaneous vertebratomy, CT scan was performed, and after reconstruction, the bone cement was filled in place in the T4 vertebra and was well distributed.
DSA-guided bilateral pedicle ablation successfully (lateral position)
Single-needle radiofrequency ablation of vertebral tumor (lateral position)
Single-needle radiofrequency ablation of vertebral tumor (positive position)
Dual channel injection of bone cement about 10ml (lateral position)
Dual channel The postoperative reconstruction of bone cement was about 10ml (positive)
PVP reconstruction showed good distribution of bone cement (sagittal position)
PVP reconstruction showed good distribution of bone cement (axial position)
PVP reconstruction showed good distribution of bone cement (axial position)
PVP reconstruction showed good distribution of bone cement (axial position)
PVP inspection rounds the next day. The patient complained that the pain was relieved by 100%, and there was no obvious discomfort and was discharged from the hospital smoothly. Receive a regular follow-up visit, and follow-up is not suitable.
