中老年患者腰背疼痛在临床上十分常见,除了由最多见的骨关节退行性变化所致的以外,还有一部分人是由于脊柱转移瘤所引起。这些患者在早期往往得不到确诊,多被贻误了治疗。本文仅对脊柱转移瘤来源途径以及如何诊断加以讨论,并附近年所见的4例误诊病例报告。例1.男性。1984年9月右肋部及背部被人撞伤。当时仅感背部及右肋部疼痛,在外院检查未见异常,按“外伤”处理。5个月以来患者疼痛加重,疼痛部位自肩胛中央向两腋环绕两季肋达双乳 Middle-aged and elderly patients with low back pain are very common in the clinic. In addition to the most common degenerative changes in bone and joints, some people are caused by spinal metastases. These patients are often not diagnosed early and are often delayed. This article discusses only the source of the spinal metastases and how to diagnose them, and reports of misdiagnosis in 4 cases seen in the nearby years. Example 1. Male. In September 1984, the right rib and back were injured. At the time, only the back and right ribs were pained. There was no abnormality in the examination at the outer hospital and they were treated as “trauma.” The patient’s pain has worsened in the past 5 months. The pain area has been surrounded by two ribs from the center of the scapula to the two ribs.