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目的:探讨前路手术治疗胸椎转移瘤的临床疗效、手术方法及手术适应证。方法:2003年11月至2005年11月收治胸椎转移瘤38例,男21例,女17例;所有患者均伴有不同程度疼痛,伴神经功能障碍29例。结果:术后随访6个月,患者疼痛均有不同程度缓解,视觉类比评分(VAS)由术前平均7.13降至术后平均1.71。术后患者使用止痛药的级别和用量均明显下降,其中多数患者(15例)无需再使用止痛药。伴神经功能障碍29例患者中,术后27例有改善,其中2例Frankel C级和9例Frankel D级患者感觉、运动基本恢复正常。局部肿瘤无复发,内固定器无松动断裂。结论:前路手术治疗胸椎转移瘤可以充分显露病灶,有利于减压以及重建脊柱稳定性,从而有效控制疼痛、防治神经功能损害,提高生存质量。
Objective: To investigate the clinical effects, surgical methods and surgical indications of anterior surgical treatment of thoracic metastases. Methods: From November 2003 to November 2005, 38 cases of thoracic metastases were treated, including 21 males and 17 females. All patients were accompanied with varying degrees of pain and neurological dysfunction in 29 cases. Results: All the patients had pain relieved to varying degrees after 6 months follow-up. The visual analogue scale (VAS) decreased from 7.13 preoperatively to 1.71 postoperatively. Postoperative patients using painkillers level and dosage were significantly decreased, most of them (15 cases) no longer need to use painkillers. Of the 29 patients with neurological dysfunction, 27 had improvement after operation, with 2 Frankel C and 9 Frankel D patients feeling and returning to normal. No recurrence of local tumor, internal fixation without loosening fracture. Conclusion: Anterior surgery for the treatment of thoracic metastases can fully reveal the lesion, which is conducive to decompression and reconstruction of spinal stability, so as to effectively control pain, prevent neurological damage and improve the quality of life.