后路全脊柱截骨肿瘤清除植骨内固定治疗胸椎肿瘤

Treatment of thoracic vertebrae tumor with posterior total vertebral resection and internal fixation

目的:探讨后路全脊柱截骨肿瘤清除植骨内固定治疗胸椎肿瘤的临床效果,为脊柱肿瘤清除重建提供一种安全、有效的手术方式。方法:自2002年1月至2007年12月收治18例胸椎肿瘤患者,男10例,女8例;年龄45～78岁,平均56岁;病程2～13个月。包括胸椎的良、恶性及转移性肿瘤,采用后路切除椎板、双侧椎弓根后椎体肿瘤完全清除,植骨、后路固定。术后摄X线片观察神经恢复情况并监测肿瘤标志物及肿瘤生长情况。结果:随访12～60个月,平均29个月,术后均无神经损害症状出现或者加重,2例截瘫患者完全恢复。X线检查:术后3～9个月,平均(8±1.4)个月植骨融合。所有患者均恢复正常生活与工作。结论:经后路全脊柱截骨肿瘤清除植骨内固定治疗胸椎肿瘤,具有肿瘤清除彻底、无须开胸手术、术后恢复快等优点,是治疗脊柱肿瘤的有效术式。

Objective：To evaluate the clinical outcome of posterior total vertebral resection in treating thoracic vertebrae tumor in order to provide a safe and effective method in rebuilding spine stability. Methods：From 2002.1 to 2007.12,18 patients with thoracic spine tumor underwent posterior total vertebral resection and internal fixation. Among the patients, 10 patients were male and 8 patients were female,ranging in age from 45 to 78 years,with an average of 56 years. The course of the diseases ranged from 2 to 13 months. After the operation,the tumor reccurence was monitored by X-ray,and the tumor markers were detected. Results：All the patients were followed up for a period ranging from 12 to 60 months,averaged 29 months. All the patients showed a postoperative neurologic improvement, as well as showed radiographic evidence of solid fusion in the follow-up examinations during 3 to 9 months, with an average of（8± 1.4） months. Conclusion：Posterior total vertebral resection for the treatment of thoracic spine tumor is safe and effective.