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目的:探讨不同节段胸椎肿瘤前方手术入路、肿瘤切除术式、前路重建技术策略及预后。方法:总结我院1997年1月至2002年5月收治的81例胸椎骨肿瘤患者的临床资料。所有患者根据肿瘤的病理类型、部位及范围行全椎体切除、次全椎体切除、全脊椎切除、次全脊椎切除,前路植骨、内固定术,术后对恶性或恶性倾向的肿瘤行化疗或放疗。结果:术后随访2～6年,4例神经症状无改善,12例患者分别于术后6～24个月局部复发,其中4例患者分别于术后16～48个月因全身多处转移,全身衰竭死亡。其余患者术后疗效均较满意,术后神经功能改善。结论:肿瘤的性质、切除方式和术后的综合治疗对预后具有重要影响,应根据肿瘤的部位、范围选择相应的手术途径及肿瘤切除方式,前路植骨内固定有利于胸椎的重建和稳定。
Objective: To investigate the surgical approaches, tumor resection procedures, anterior reconstruction techniques and prognoses in different segments of thoracic tumors. Methods: To summarize the clinical data of 81 patients with thoracic bone tumors admitted to our hospital from January 1997 to May 2002. All patients underwent radical resection, subtotal vertebral resection, total spondylectomy, subtotal spondylotomy, anterior bone grafting and internal fixation according to the pathological type, location and extent of the tumor, postoperative resection of the malignant or malignant tumor Chemotherapy or radiotherapy. Results: After 2 to 6 years of follow-up, there was no improvement in neurological symptoms in 4 patients. Twelve patients relapsed locally 6 to 24 months postoperatively. Four of them had multiple metastases at 16 to 48 months postoperatively , Systemic failure death. The remaining patients were satisfied with postoperative efficacy, postoperative neurological function improved. CONCLUSIONS: The nature of the tumor, the mode of resection and the postoperative comprehensive treatment have an important influence on the prognosis. According to the location and range of the tumor, appropriate surgical approaches and tumor resections should be selected. Anterior bone grafting and internal fixation are beneficial to the reconstruction and stabilization of the thoracic vertebra .