前后路全脊椎切除治疗下颈椎原发骨肿瘤  

The Total Spondylectomy Via Anterior-posterior Approaches in the Treatment of Lower Cerival Spinal Primary Tumors

作　　者：李龙[1] 陈阳[2] 周建伟[2] 马华松[1,2] 周雪峰[2] 王蒙[2] 徐启明[2] 

机构地区：[1]安徽医科大学解放军306医院临床学院,北京100101 [2]解放军306医院骨科全军脊柱外科中心,北京100101

出　　处：《实用骨科杂志》2014年第5期401-405,共5页Journal of Practical Orthopaedics

摘　　要：目的探讨前后联合入路全脊椎切除治疗下颈椎原发肿瘤的疗效。方法对我院14例下颈椎原发肿瘤采用前后联合入路全脊椎切除,前后联合内固定系统重建下颈椎稳定性。记录并比较术前、术后颈部疼痛视觉模拟评分（visual analogue score,VAS）、神经功能日本骨科协会（Japanese orthopaedic association,JOA）评分及Frankel分级,并随访下颈椎植骨融合率。结果 14例均获得随访,随访时间8～54个月。术前和术后颈部疼痛VAS评分分别为（5.43±1.60）分和（2.00±1.30）分,术后疼痛显著缓解（P〈0.05）。术后神经功能改善情况按JOA评分法评估神经功能改善率（rate of the improve JOA score,RIS）达63.8%。根据Frankle分级标准,术后神经功能可改善1～2级。术后随访1年内植骨融合率达92.8%。结论采用前后联合入路全脊椎切除治疗下颈椎原发肿瘤,可最大可能完整切除肿瘤组织,重建下颈椎稳定性,获得满意的疗效。Objective To explore the clinical effect of total spondylectomy via anterior-posterior approaches in the treatment of lower cerival spinal primary tumors. Methods In our hospiatal,14 cases of lower cervical spinal primary tumors received total spondylectomy via anterior-posterior approaches. The stability of lower cerival spine was reconstructed via anterior and posterior internal fixation. We recorded and contrasted VAS score,JOA criteria and Frankle classification of all cases before and after surgery. The rate of fusion was followed up. Results 14 cases received postoperative follow-up,ranging from 8 months to 54 months. The preoperative and postoperative VAS score were respectively（ 5. 43 ± 1. 60） and（ 2. 00 ± 1. 30）. The nerve function was categorized by JOA criteria and Frankle classification,the excellent rate of JOA criteria was 63. 8%. An average impovment of 1 ～ 2 Frankle grade was achieved in most cases after surgery. The rate of fusion was 92. 8% after 1 year. Conclusion The total spondylectomy via anterior-posterior approaches in the treatment of lower cerival spinal primary tumors could resected the tumor tissue completely as soon as possible,and reconstructe the stability of lower cervical spine and acquire satisfactory effect.

关 键 词：原发骨肿瘤 全脊椎切除 前后路 

分 类 号：R738.1[医药卫生—肿瘤]