分离手术联合立体定向放射治疗脊柱转移瘤的临床效果分析

Clinical efficacy of separation surgery combined with stereotactic radiotherapy in the treatment of patients with spinal metastases

目的:探究分离手术(SS)联合立体定向放射外科(SRS)治疗脊柱转移瘤的临床效果。方法:选取脊柱转移瘤患者27例作为研究对象,根据治疗方法不同进行分组,采用SS联合SRS疗法的14例患者为A组,采用全脊椎整块切除术(TES)联合SRS治疗的13例患者为B组。收集分析两组手术时间、术中出血量、VAS评分、Frankel神经功能评分、Karnofsky评分、手术并发症及预后等指标。结果:A组手术时间及术中出血量较B组低,术后并发症A组少于B组,两组比较差异有统计学差异(P<0.05);两组术后VAS评分、Frankel评分和Karnofsky评分较术前均有明显改善,但两组间比较无统计学差异(P>0.05),两组术后6个月随访均未见有转移瘤复发。结论:SS联合SRS治疗可以改善疼痛、神经功能及生活质量,且手术时间短,出血量少,安全性高。

Objective:To explore the clinical efficacy of separation surgery(SS)combined with stereotactic radiosurgery(SRS)in the treatment of patients with spinal metastases.Methods:27 patients with spinal metastatic tumor were selected as the study objects,and divided into two groups according to different treatment methods.14 patients received the combined treatment of SS and SRS were included in group A,while 13 patients treated with total enbloc spondylectomy(TES)combined with SRS were included in group B.The operation time,intraoperative blood loss,VAS score,Frankel neurological function score,Karnofsky score,surgical complications and prognosis were collected and analyzed between the two groups.Results:The operation time,intraoperative blood loss and postoperative complications in group A were less than that in group B,and there was statistical difference between both group(P<0.05);the VAS score,Frankel score and Karnofsky score of the two groups after surgery were significantly improved,but there was no statistical difference between the two groups(P>0.05),and no recurrence of metastatic tumor was found in patients during the two-month follow-ups six months after surgery.Conclusion:Separation surgery combined with stereotactic radiotherapy can improve pain,neurological function and quality of life in patients,with shorter operation time,less bleeding and higher safety.