肿瘤姑息切除结合骨水泥强化治疗多发性胸腰椎转移性肿瘤的一年期临床观察  

A one-year clinical observation of tumor palliative resection combined with vertebroplasty for the treatment of metastases in the thoracolumbar spine

作　　者：杨雷[1] 顾洪生[1] 张睿[1] 周文钰[1] 

机构地区：[1]深圳市第二人民医院(深圳大学第一附属医院)脊柱外科,广东深圳518035

出　　处：《岭南现代临床外科》2016年第4期468-471,共4页Lingnan Modern Clinics in Surgery

基　　金：广东省深圳市卫计委重点专科提升项目(201506027)

摘　　要：目的：探讨对于已经出现脊髓或神经根压迫的多发性胸腰椎转移瘤手术治疗的方法和效果。方法采用回顾性研究,对2013~2015年本院收治有完整随访资料的19例多发性胸腰椎转移瘤并出现神经功能受损手术患者,采用后路肿瘤姑息切除椎弓根螺钉固定结合骨水泥充填椎体强化治疗,术后随访1年期内,定期观察术后患者生存质量（包括疼痛、睡眠、食欲）改善程度和神经功能恢复程度。结果全组19例患者术后生存质量（疼痛、食欲、睡眠）获得显著改善（与术前比较P＆lt;0.01）,术后三月约78.9%的患者神经功能获得至少 Frankel 1级以上恢复。脊椎稳定性得到加强,在1年随访期内未见内固定松动移位。1例患者在随访期内死亡,2例患者出现局部复发（10.53%）。结论对于已经出现脊髓或神经根压迫的多发性胸腰椎转移瘤患者,肿瘤姑息切除结合骨水泥注射强化治疗可以在近期内有效改善晚期肿瘤患者神经功能恢复以及提高患者的生存质量。Objective To assess the surgical treatment and effectiveness for the metastases in thoracolumbar spine which have caused spinal cord compression. Methods From 2013 to 2015, there were 19 patients in our hospital with spinal bone metastases and the emergence of neurological dysfunction had accepted the treatments including tumor palliative resection and pedicle screw system fixation combined with bone cement filling vertebral intensive treatment to observe the postoperative quality of life （including pain, sleep, appetite） and the improvement of neurological recovery. Results All surgical procedures were succesfully done,and the spine was stable. The postoperative pain, appetite, sleep was significantly improved （compared with the preoperative P〈0.01）, and 63% of patients with neurological function was restored at least Frankel 1 level and above. Conclusion Tumor palliative resection combined with vertebroplasty is relatively simple, safe and can effectively improve the life quality of the patients suffered spinal metastases.

关 键 词：脊柱转移瘤 姑息切除 椎体成形术 骨水泥 

分 类 号：R681.5[医药卫生—骨科学]