后路一期椎体全切除治疗胸椎椎体肿瘤  

Treatment of Bone Tumor of Thoracic Spine by Total Spondylectomy

作　　者：刘国太[1] 周学文[1] 佟杰[1] 董康然[1] 张居适[1] 

机构地区：[1]绍兴文理学院附属医院骨科,浙江绍兴312000

出　　处：《实用骨科杂志》2011年第8期681-684,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨后路一期手术治疗胸椎肿瘤的疗效及方法。按脊柱肿瘤来源可分为原发肿瘤,转移肿瘤。方法 8例胸椎骨肿瘤患者实施后路全脊椎切除重建术。经胸椎后入路行单椎节切除6例,双椎节切除2例,均采用Harm钛网植骨/钛网骨水泥联合TSRH/MOSS/CDH M12椎弓根钉内固定系统重建。结果随访3个月3.5年,平均23个月。7例术后近期疗效较满意,局部疼痛和神经症状均有不同程度改善或缓解;4例脊髓神经功能完全恢复;1例术后1.5年局部复发;术后18个月死亡1例。结论胸椎后路全脊椎切除能显著降低胸椎骨肿瘤局部复发率,改善脊髓神经功能,提高手术疗效。钛网植骨/钛网骨水泥联合椎弓根螺钉系统能有效重建脊柱的前后柱稳定,同时可减少创伤、缩短手术时间、减少并发症的发生。Objective To investigate the effects and approaches of the posterior thoracic oncology surgery.According to the origin of the spinal tumors,it can be divided into the primary tumor and the metastatic brain tumor.Methods 8 consecutive cases with bone tumor of thoracic spine who underwent total spondylectomy and stability reconstruction through poster lateral approach were evaluated retrospectively.One and two segments total spondylectomy were performed by posteriolateral approach successfully on 6 cases and 2 case respectively.Titanium mesh filled by iliac bone block or bone cement combined with posterior pedicle screw system as TSRH/MOSS/CDH M8 were used to reconstruct stabilility of spine.Results The following up period was from 3 months to 3.5 years.The recent effects after operation were satisfactory in 7 cases,with complete recovery of spinal cord function in 4 cases.1 case with local recurrence after 1.5 years,1 case with unknown origin death after 18 months.Conclusion Poster lateral approach to total spondylectomy and reconstruction for bone tumor of thoracic spine contributes to decreasing local recurrence,improving function of spinal cord and enhancing operative effect.Titanium mesh filled by iliac bone block or bone cement combined with posterior pedicle screw system provides effective and strong stability reconstruction of both anterior and posterior columns of spine.Poster lateral approach presents advantages on decreasing trauma,shortening operative time and reducing complications.

关 键 词：椎体 肿瘤 切除 

分 类 号：R738.1[医药卫生—肿瘤]