目的:探讨经皮成形术(PVP)联合放疗治疗脊椎骨转移瘤的方法及疗效。方法:对26例经病理学证实的42个病变椎体行PVP。骨水泥按粉、液、对比剂3:2:1比例配制。胸腰骶椎区均采用经椎弓根或椎体后外侧穿刺,在确定穿刺到位并无椎管内渗漏后,将骨水泥快速灌注至椎体内。灌注量为胸椎平均4.6m l,腰椎平均5.4m l,骶椎平均5.5m l。术后观察患者疼痛缓解程度,并于当日、1个月CT检查注射椎体。放疗在PVP后第3～4天开始,采用60CO照射,2～3Gy/次,总量35～45Gy/3～4周。结果:穿刺成功率100%。本组26例单侧穿刺32个椎体,双侧穿刺10个椎体。CT检查骨水泥周围组织渗漏2例,但均未出现临床症状。26例放疗过程顺利。PVP后止痛有效率为80.8%(21/26),联合放疗后,止痛有效率上升至96.2%(25/26)。随访4～10个月,止痛有效率在10个月内为88.5%(23/26)。结论:PVP有靶区硬度压强和快速缓解疼痛的作用,放疗能强化对肿瘤的抑制,从而达到提高疗效的目的。 Objective: To investigate the method and efficacy of percutaneous angioplasty (PVP) combined with radiotherapy in the treatment of spinal bone metastases. Methods: PVP was performed on 26 lesions confirmed by pathology. Bone cement, liquid, contrast agent 3: 2: 1 ratio of preparation. Thoraco-lumbosacral region by pedicle or vertebral posterolateral puncture in determining the puncture in place without leakage of the spinal canal, the rapid infusion of bone cement to the vertebral body. The perfusion volume was 4.6m l for the thoracic spine, 5.4m l for the lumbar spine, 5.5m l for the sacral spine. Postoperative pain relief in patients with observation, and on the same day, 1 month CT examination of the injection of vertebral body. Radiotherapy began 3 to 4 days after PVP, 60CO irradiation, 2 ~ 3Gy / time, the total 35 ~ 45Gy / 3 ~ 4 weeks. Results: Puncture success rate of 100%. The group of 26 cases of unilateral puncture 32 vertebral body, bilateral puncture 10 vertebral body. CT examination of bone tissue around the leakage of 2 cases, but no clinical symptoms. 26 cases of radiotherapy went well. After PVP analgesic effective rate was 80.8% (21/26), combined radiotherapy, analgesic effective rate increased to 96.2% (25/26). Follow-up 4 to 10 months, analgesic effective rate within 10 months was 88.5% (23/26). Conclusion: PVP has the target area hardness pressure and rapid pain relief, radiotherapy can strengthen the inhibition of the tumor, so as to achieve the purpose of improving the curative effect.