骶骨肿瘤的手术治疗

Surgical treatment of the sacrum tumor

目的:探讨骶骨肿瘤的手术治疗方法及其疗效。方法:15例骶骨肿瘤患者,男12例,女3例;年龄17～68岁,平均54.6岁。原发性肿瘤10例,转移性肿瘤5例。采用前方入路病灶清除5例,后方入路单纯病灶清除3例,病灶清除联合植骨加钉棒系统内固定重建7例。术后根据肿瘤性质辅助放疗或化疗。结果:13例获随访,时间4个月～5年,所有患者近期疗效满意,局部疼痛及神经症状均有不同程度的改善。1例术后出现二便功能障碍加重,经保守对症治疗4个月后好转。1例脊索瘤和2例转移瘤于术后1～2年死于复发和远处转移。1例骨巨细胞瘤于术后6个月局部复发,未再手术。结论:根据骶骨肿瘤患者特点制定个体化的以手术治疗为主的综合治疗方案,能得到较满意疗效。

Objective： To discuss the surgical methods and effects in the treatment of sacrum tumor. Methods ： Fifteen patients of sacrum tumor included 12 males 3 females aged from 17 to 68 years old ,mean 54.6 years. Ten cases were primary tumor and 5 were metastatic tumor. Five cases underwent anterior approach tumor extirpation,3 posterior approach tumor extirpation and 7 posterior tumor extirpation with bone graft and internal fixation of a pedicle screw and rod system. Additionally, all cases were treated with radiotherapy or/and chemotherapy post-operatively according to the character of the tumor. Results. Thirteen patients were followed-up for 4 months to 5 years. One patient had exacerbation accompanying dysfunction of urinary and feca after surgery,which relieved after four months of non-operative treatments. One chordoblastoma and 2 metastatic tumor died of recurrence and metastasis 1 to 2 years after operation, respectively. And in another case of giant cell tumor occurred the local recurrence 6 months after operation, who refused secondary surgical treatment. Conclusion：Individualized surgical treatment with conbination of radio therapy or/and chemotherapy will make good results for patients with sacrum tumor.