后外侧入路治疗胸腰椎转移癌

Treatment of spinal metastases by posterolateral approach

目的:探讨应用后外侧入路行病灶切除,椎管环状减压、脊柱重建治疗胸腰椎转移癌效果。方法:1 3例患者采用后外侧入路,切除受累椎体、附件、硬膜外肿瘤实现环状减压;用椎弓根内固定系统及骨水泥重建脊柱稳定性。通过疼痛缓解及神经症状改善的程度来分析临床结果。结果:全部患者术后疼痛均明显缓解,6例有神经症状患者术后均有改善,无内固定失败。结论:对多节段或三柱均受累及既往放疗、胸部手术史不能行前路手术的脊柱转移癌患者,采用后外侧入路行病灶切除、环状减压、脊柱重建是一种切实可行的方法。

Objective To evaluate the value of spondylectomy, circumferential decompression, and spinal reconstruction for the treatment of spinal metastases using posterolater approach. Methods Thirteen patients with spinal metastases were treated by spondylectomy, circumferential spinal cord decompression, and spinal reconstruction with pedicle fixation and polymethyl methacrylate. The outcome was assessed by pain relief and the improvement in neurologic symptoms. Results Pain relief was obvious in all patients. Neurologic symptoms improved to various degrees in 6 patients. Conclusion Spondylectomy, spinal cord circumferential decompression and spinal reconstruction with pedicle fixation and polymethyl methacrylate using posterolateral approach are effective surgical method for spinal metastases.