总结丹麦卫生局发布的国家临床指南的建议,关于骨水泥增强治疗疼痛的椎体病变,恶性疾病患者。
一个多学科工作组根据GRADE方法制定了建议。
其中两个问题基于随机研究,一个基于专业共识。该指南建议对恶性诊断的患者进行骨水泥强化治疗疼痛性椎体病变,血液学或非血液学。后壁骨折与骨水泥增强并不矛盾,但是注射水泥时应该小心,降低牙骨质渗漏进入椎管的风险。
这些建议基于低到中等质量的证据或专业共识,以及患者的偏好和干预的积极和有害影响。工作组建议对患有不同恶性疾病和疼痛性椎体病变的患者进行更多的随机研究,比较经皮椎体成形术/椎体后凸成形术和保守治疗,以证实本指南的结论。这些幻灯片可以在电子补充材料下检索。
To summarize the recommendations from the national clinical
guideline published by the Danish Health Authority, regarding cemental augmentation as treatment for painful vertebral lesions, in patients with malignant disease.
A multidisciplinary working group formulated recommendations based on the GRADE approach.
Two of the questions were based on randomized studies and one on professional
consensus. The
guideline recommends cemental augmentation for painful vertebral lesions in patients with malignant diagnosis, either hematological or non-hematological. Fracture of the posterior wall is not a contradiction to cemental augmentation, but care should always be taken while injecting the cement, to decrease the risk of cemental leaks into the spinal canal.
The recommendations are based on low-to-moderate quality of evidence or professional
consensus as well as patient preferences and positive and harmful effects of the intervention. The working group recommends more randomized studies on patients with different malignant diseases and painful vertebral lesions comparing percutaneous vertebroplasty/kyphoplasty and conservative treatment to confirm the conclusion in this
guideline. These slides can be retrieved under Electronic Supplementary Material.