胸腰椎转移肿瘤的手术切除和稳定性重建

The method-decision of surgical treatment and reconstruction for thoracolumbal metastasis

目的探讨胸腰椎转移肿瘤的手术切除方式和脊柱稳定性重建方法的选择。方法对12例胸腰椎转移肿瘤分别采用前路,后路及前后路联合肿瘤病灶切除加人工椎体替代物辅助器械内固定稳定手术,术后配合相应放、化疗。结果无手术相关死亡病例。随访6个月-3年,近期疗效均较满意,局部疼痛或神经根痛缓解,神经功能有不同程度改善,生存质量明显改善。结论手术治疗胸腰椎转移肿瘤是可行的,积极的肿瘤切除与可靠的脊柱重建能为病人解除临床症状并能获得稳定的脊柱。胸腰椎转移肿瘤的手术治疗,要根据各方面情况选择最佳的入路、肿瘤切除和重建方式。

【Objective】To explore the method-decision of surgical treatment and reconstruction for thoracolumbal metastasis.【Methods】We respectively performed the posterior or anterior approach or one stage anterior and posterior approach for lesions resection and artificial vertebra replacement with instrumentation.All patients were accepted relative radiotherapy and chemotherapy postoperatively.【Results】No patient died of relative operation-complication,all patient were followed about 6 month to 4 years.Postoperatively short term curative effect was satisfactory and local pain and nerve pain were relieved.neurological function had improved and life quality was increased.【Conclusion】It is possible to perform the operation for the thoriacolumbar metastasis.With positive tumor resection and reliable spine column reconstruction can palliated clinical symptom and achieve stable situation.The life-quality of metastasis patients can be improved.For the surgical treatment of the thoraciaolumbar metastasis,The best approach and methods of the resection and reconstruction must be chosen for defferent cases.