上胸椎肿瘤手术治疗后的椎体重建

The vertebral reconstruction after surgical treatment for tumors located in upper thoracic vertebral bodies

目的 :探讨上胸段脊柱肿瘤椎体切除手术治疗后椎体的重建方法。方法 :对 19例侵犯椎体的上胸椎肿瘤经不同途径前入路切除肿瘤后 ,应用髂骨植骨 1例、肋骨植骨 6例、钛网植骨 8例、人工椎体 5例进行椎体重建替代 ,并辅以前路内固定系统行邻近椎节固定。随访 1～ 43个月。结果 :各种方式植骨进行重建 19例患者均安全度过围手术期 ,患者 1个月后均可坐起进食。 17例术后神经功能有不同程度改善 ,2例无明显改善。均无明显椎体替代物下沉现象 ,无断钉及内固定脱落。结论 :上胸椎肿瘤椎体切除术后应用髂骨、肋骨、钛网、人工椎体进行重建替代 ,均可良好恢复术后椎体高度及脊柱的稳定性。人工椎体的应用能进一步缩短患者卧床时间。

Objective:To research the results of the vertebral reconstruction after surgical treatment for tumors located in upper thoracic vertebral bodies.Method:Diagnosed as tumors located in upper thoracic vertebral bodies,19 cases underwent anterior resection,spinal cord decompression,bone graft by anterior approach.The vertebral were reconstructed with ilium for 1 case,ribs for 6 cases,Titanium reticulum for 8 cases and artificial vertebral bodies for 5 cases.The neighbor vertebral were immobilized by anterior fixation system aid.The patients were followed up for 1～43 months.Result:Having stood surgery well,all patients with different kinds of grafts can sit up for eating in a month.17 cases had improvements of the neural symptoms on different degrees.There was no submerge into the bodies of the placement,no breakage of the nails or fall of the internal fixation during the follow-up.Conclusion:The vertebral height and the spinal stability can be well restored by varied kinds of replacement with ilium,ribs,Titanium reticulum and artificial vertebral bodies during the surgical treatment on tumors located in upper thoracic vertebral bodies.The application of the vertebral body can reduce the postoperative bed-rest.