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IlluminOss photodynamic bone stabilization system improves pain and function in the treatment of humeral metastatic disease.
The Bone & Joint Journal ( IF 4.9 ) Pub Date : 2024-12-01 , DOI: 10.1302/0301-620x.106b12.bjj-2023-1089.r2
Richard M Terek,,Richard McGough,Nicola Fabbri,Felix Cheung,Brian Brigman,James Wittig,Cynthia Emory,Albert Aboulafia,Raffi Avedian,Joel Mayerson,Robert Henshaw,Nickolas Reimer,William Eward,Kurt Weiss,John Healey,David Mohler,Brock Adams

Aims The aim of the LightFix Trial was to evaluate the clinical outcomes for one year after the treatment of impending and completed pathological fractures of the humerus using the IlluminOss System (IS), and to analyze the performance of this device. Methods A total of 81 patients with an impending or completed pathological fracture were enrolled in a multicentre, open label single cohort study and treated with IS. Inclusion criteria were visual analogue scale (VAS) Pain Scores > 60 mm/100 mm and Mirels' Score ≥ 8. VAS pain, Musculoskeletal Tumor Society (MSTS) Upper Limb Function, and The European Organization for Research and Treatment of Cancer QoL Group Bone Metastases Module (QLQ-BM22) scores were all normalized to 100, and radiographs were obtained at baseline and at 14, 30, 90, 180, and 360 days postoperatively. Results The mean VAS pain score decreased significantly from 84 (SD 15) to 50 (SD 29), 38 (SD 30), 31 (SD 29), 31 (SD 29), and 21 (SD 23) between the baseline and follow-up times (p < 0.001). The mean MSTS function scores significantly increased from 27 (SD 19) to 52 (SD 22), 60 (23), 67 (SD 23), 72 (SD 26), and 83 (SD 14) (p < 0.001). The pain and functional subscales of the QLQ-BM22 also significantly improved at most times. A total of 12 devices broke, giving an unadjusted device fracture rate of 15%. Conclusion Stabilization with the IS decreased pain and improved function with consistent results during the first postoperative year. IS is a new, minimally invasive type of internal fixation. The use of the IS alone may be better for impending rather than completed pathological fractures, and may be better in completed fractures if an added plate or more than the usual number of locking screws is required. Caution is warranted regarding its use alone in patients with a completed pathological fracture due to the rate of breakage of the device.

中文翻译:


IlluminOss 光动力骨稳定系统在治疗肱骨转移性疾病时改善疼痛和功能。



目的 LightFix 试验的目的是评估使用 IlluminOss 系统 (IS) 治疗即将发生和已完成的肱骨病理性骨折后一年的临床结果,并分析该设备的性能。方法 共有 81 例即将发生或完全病理性骨折的患者被纳入一项多中心、开放标签的单队列研究,并接受 IS 治疗。纳入标准为视觉模拟量表 (VAS) 疼痛评分 >、60 mm/100 mm 和 Mirels 评分 ≥ 8。VAS 疼痛、肌肉骨骼肿瘤协会 (MSTS) 上肢功能和欧洲癌症研究与治疗组织 QoL 组骨转移模块 (QLQ-BM22) 评分均标准化为 100,并在基线和术后 14 、 30 、 90 、 180 和 360 天获得 X 线片。结果 平均 VAS 疼痛评分在基线和随访时间之间从 84 (SD 15) 显著降低至 50 (SD 29) 、38 (SD 30)、31 (SD 29)、31 (SD 29) 和 21 (SD 23) (p < 0.001)。平均 MSTS 功能评分从 27 (SD 19) 显着增加到 52 (SD 22)、60 (23)、67 (SD 23)、72 (SD 26) 和 83 (SD 14) (p < 0.001)。QLQ-BM22 的疼痛和功能分量表在大多数情况下也显着改善。共有 12 个器件损坏,未经调整的器件断裂率为 15%。结论 IS 稳定术后第一年疼痛减轻,功能改善,结果一致。IS 是一种新型的微创内固定。对于即将发生的病理性骨折,单独使用 IS 可能比完全性病理性骨折更好,如果需要增加钢板或超过通常数量的锁定螺钉,则可能更适合完全性骨折。 由于设备的破损速度,在完全病理性骨折患者中单独使用时需要谨慎。
更新日期:2024-12-01
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