论文部分内容阅读
目的:探讨经后路全脊椎切除治疗腰椎肿瘤的方法及疗效。方法:对腰椎肿瘤患者,经后路一期全脊椎切除手术治疗,所有病例术前均根据Tomita脊椎肿瘤外科分期进行评估,采用VAS评分对疼痛症状进行评定,并用Frankel分级对神经功能进行评估。结果:平均术中出血量4560 mL,平均手术时间255 min。随诊6月～36月,平均24.6个月,在随访期内原发肿瘤患者无复发,转移癌患者1例全身多处转移术后18月死亡,1例局部复发并其他节段转移,余无局部复发,带瘤生存。术后所有病例腰部疼痛症状缓解或明显减轻,神经功能均获得改善。结论:对具有适应征的腰椎肿瘤患者进行后路一期全脊椎切除重建术,可以获得有效的局部控制和神经功能恢复,得到稳定的椎体重建,近期疗效满意,提高了患者的生存质量,远期疗效仍需进一步随访。
Objective: To investigate the method and effect of trans-posterior total spondylectomy for lumbar tumors. Methods: The patients with lumbar tumor were treated with total anterior spondylotomy via posterior approach. All cases were evaluated preoperatively according to the surgical staging of Tomita spine tumor. VAS scores were used to assess the pain symptoms and Frankel grading was used to evaluate the neurological function. Results: The average intraoperative blood loss 4560 mL, the average operation time 255 min. Followed up from June to 36 months, an average of 24.6 months, no recurrence of primary tumor patients during the follow-up period, one case of metastatic cancer died of multiple metastases 18 months after surgery, one case of local recurrence and other segmental metastasis, No local recurrence, with tumor survival. Postoperative patients with lumbar pain relief or significantly alleviate the symptoms, neurological function have been improved. Conclusion: The posterior one-stage total spondylectomy for patients with lumbar spine cancer who have indications can obtain effective local control and neurological function recovery and obtain stable vertebral body reconstruction. The short-term effect is satisfactory and the quality of life of patients is improved. Long-term efficacy still need further follow-up.