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目的 探讨后路I期全脊椎整块切除术在胸腰椎原发和转移性肿瘤患者中的临床疗效.方法 对38例胸腰椎原发或转移性肿瘤患者采用后路I期全脊椎整块切除术治疗,于手术前及手术后3个月分别采用视觉模拟评分法评定本组患者的疼痛程度,采用健康调查简表评定生存质量,采用Frankel脊髓损伤分级评定脊髓损伤程度.统计随访期间本组患者复发率、死亡率、生存时间及并发症情况.结果 手术后3个月本组视觉模拟评分法评分较手术前显著降低(P＜0.01),健康调查简表评分较手术前显著升高(P＜0.01).手术后Frankel脊髓损伤分级B级、C级患者显著少于手术前,D级、E级患者显著多于手术前(P＜0.05).本组患者手术中均无大血管损伤导致的大量出血,骨水泥填充均完全愈合,无内固定失败、钛网或人工椎体移位现象发生.术后并发症经相关对症支持治疗后均明显好转或消失,未对治疗产生不良影响.结论 后路I期全脊椎整块切除术能够有效减轻胸腰椎原发性与转移性肿瘤患者的疼痛程度,改善神经功能障碍,提高生存质量,安全性高,值得临床推广.“,”Objective To discuss the clinical effects of one-stage posterior TES in patients with primary or metastatic tumors of the thoracolumbar spine. Methods 38 patients with primary or metastatic tumors of the thoracolumbar spine were treated with one-stage posterior TES,then the VAS,SF-36,Frankel classification of nervous function were used to evaluate the pain degree, life quality, degree of spinal cord injury of patients. The recurrence rate,death rate, survival time and complications of patients during the follow up were analyzed. Results 3 months after operation, the VAS scores of patients were significantly lower than those before operation (P＜0.01),the SF-36 scores were significantly higher than those before operation (P＜0.01). Patients with B,C level of Frankel SCI classification after operation were significantly less than those before operation, patients with D,E level were significantly higher than those before operation (P＜0.05). There was no major vascular injury, and bone cement filling was completely healed, no internal fixation failure, no titanium mesh or artificial vertebral body displacement. Postoperative complications were all improved markedly or disappeared after symptomatic and supportive treatment, no adverse effects occurred. Conclusion One-stage posterior TES can effectively relieve the pain,improve the neurological dysfunction and the quality of life in patients with primary or metastatic tumors of the thoracolumbar spine, it is safe and is worthy of promotion.