颈椎骨肿瘤的外科治疗讨论

A discussion on the surgical treatment of cervical bone tumors

目的 :研究颈椎骨肿瘤的手术处理方式。方法 :回顾复习 1990年以后我科治疗 42例颈椎骨肿瘤 (包括肿瘤样变 )的临床肿瘤 ,共归纳为 7种外科处理方式。结果 :平均 2 5个月随访结果显示 ,在 2 9例原发骨肿瘤患者中 ,1例C2 巨细胞瘤复发导致病人死亡 ,2例恶性肿瘤死于全身转移 ,1例巨细胞瘤及 1例血管瘤复发再手术成功 ,其余 2 4例手术均达到预期结果。在 13例转移癌患者中手术起到了缓解脊髓、神经根压迫及颈部疼痛症状。结论 :根据不同的肿瘤性质和实际侵犯脊椎的程度应计划不同的手术方式。对原发肿瘤 ,应根据Weistein的分期理论采取较为彻底地切除方式 ,对 3期 ,Ⅰ、Ⅱ期病例术后辅以放疗。对转移癌病例的手术治疗旨在缓解脊髓和神经根受压 ,重建脊柱的稳定性。

Objectives:To study the surgical treatment of cervical osseous tumors.Methods:Since 1990,forty two cases with cervical osseous tumors(including tumoroid lesions)have been treated in our department with a total of seven methods.Results:The results of a follow up of an average of twenty five months showed that,among twenty nine cases with primary tumors,twenty four cases had expected good result.Three cases died,one with C 2 giant cell tumor died of relapse and the other two of metastasis.Two cases with giant cell tumors were relapsed but reoperated on successfully.Operation reduced symptoms in thirteen cases with metastatic lesions.Conclusions:Based on the study of tumor grade and its invasion site,surgery should be planned to every individual case.According to Weistein's staging theory,a comparatively wild resection should be performed to stage 3,Ⅰ、Ⅱ cases followe by radiological therapy.Surgery in metastatic cases aims at reduction of symptoms.