一期后路全脊椎切除治疗胸椎转移瘤的临床疗效研究

Clinical Efficacy of One-stage Posterior Total Spondylectomy for the Treatment of Thoracic Vertebra Metastases

目的:探讨一期后路全脊椎切除术治疗胸椎转移瘤的临床效果。方法:回顾性分析29例胸椎转移瘤患者采用一期后路全脊椎切除术的治疗效果。结果:手术时间为240 min～430 min,平均280 min;术中失血量约为1 100～4 300 mL,平均2 200 mL。所有病例术前、术后VAS疼痛评分和SF-36生活质量评分结果比较均有统计学意义(P<0.05)。术后1年患者的神经功能恢复正常者23例,C级2例,D级1例(1例死亡和2例随访低于1年,未进行神经功能评估)。结论:一期后路全脊椎切除术治疗胸椎转移瘤能够明显改善患者的生存质量,延长患者生存时间,促进脊髓神经功能的恢复,保护或者恢复患者的运动功能。

Objective：To discuss the clinical effect of one-stage posterior total spondylectomy for the treatment of thoracic vertebra metastases. Methods：The effect of 29 cases with thoracic vertebra metastases treated by one-stage posterior total spondylectomy were retrospectively analyzed. Results：The operation time was 240min^430min,and the average time was 280min;the blood loss volume during operation was 1 100~4 300mL,with the average of 2 200mL.The results of VAS pain score and SF-36 living quality score before and after operation had statistical significance（P0.05）.The nerve function of 23 cases returned to normal after one year,and 2 cases in C level,1 case in D level（one case died and two cases＇ follow-up time shorter than one year,so their nerve function was not evaluated）. Conclusion：The treatment of thoracic vertebra metastases with one-stage posterior total spondylectomy can obviously improve patients＇ quality of life,prolong survival time,accelerate the recovery of neurological function of spinal cord,and protect or regain their motor function.