环形减压结合骨水泥填充隔离治疗脊柱转移瘤  

Circumferential resection decompression combined with bone cement fill-separation for treatment of spine metastatic tumor

作　　者：王亚楠[1] 李青松[1] 谢梦琦 王琪[1] WANG Ya-nan;LI Qing-song;XIE Meng-qi;WANG Qi(Department of Orthopedic, General Hospital of Shenyang Military, AreaCommand,Shenyang Liaoning 110000, China)

机构地区：[1]沈阳军区总医院骨科,辽宁沈阳110000

出　　处：《局解手术学杂志》2017年第11期818-822,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨脊柱360°环形减压结合骨水泥填充隔离、椎弓根钉棒系统内固定术治疗脊柱转移瘤的临床疗效。方法回顾性分析2012年4月至2016年10月于我院行脊柱360°环形减压结合骨水泥填充隔离、椎弓根钉棒系统内固定术的42例脊柱转移瘤患者的临床资料。术前、术后1周、术后3个月应用视觉模拟评分(VAS)评估疼痛程度,应用卡氏评分(KPS)评估功能状态,应用Frankel分级评估脊髓损伤。结果 42例患者术后随访3个月显示,未再次出现原节段神经症状,术后3个月VAS评分为(0.57±0.79)分,KPS评分为(72.61±19.12)分,两项评分相较于术前均有明显改善,差异具有统计学意义(P<0.05),VAS改善率为(91.09±13.73)%,Frankel分级改善率为80%。结论环形减压结合骨水泥填充隔离治疗脊柱转移瘤可以有效改善脊柱转移瘤患者的疼痛及神经症状,提高患者生活质量,避免术后于原节段再次出现神经症状。ObjectiveTo explore the effect of spinal 360°circumferential resection decompression combined with bone cement fill separation and pedicle screw fixation instrumentationb for patients suffering from spinal metastases.MethodsRetrospectively analyzed the clinical data of 42 patients suffering from spinal metastases and underwent spinal 360°circumferential resection decompression combine with bone cement fill separation and pedicle screw fixation instrumentation in our hospital from April 2012 to October 2016.The pain level were assessed by visual analogue scale（VAS）,the functional impairment was classified by Karnofsky score（KPS） and the neurologic deficit was evaluated by Frankel grade before preoperation,1 week after operation and 3 months after operation.ResultsThrough the following up of 3 months,there was no neural symptoms relapse in primary segment.The VAS score was （0.57±0.79） points,and the KPS was （72.61±19.12） points 3 months after operation,which were significantly improved compared with the data before operation（P〈0.05）.The VAS score improvement rate was （91.09%±13.73%）,and the Frankel grade improvement rate was 80%.ConclusionCircumferential resection decompression combined with bone cement fill separation and pedicle screw fixation instrumentationb for patients suffering from spinal metastases can effectively improve the neural symptoms and life quality of patients and prevent neural symptoms relapsing in primary segment after operation.

关 键 词：脊柱转移瘤 环形减压 脊髓减压 骨水泥 

分 类 号：R738.1[医药卫生—肿瘤]