椎体成形术结合后路短节段椎弓根固定治疗16例胸、腰椎转移性肿瘤

Verteborplasty combined with posterior brevi-segment fixation with pedicle screw in the treatment of thoracolumbar spinal metastatic tumor in 16 cases

目的探讨后路短节段椎弓根钉棒系统结合瘤椎内骨水泥填充,治疗胸、腰椎转移性肿瘤的临床疗效。方法对2007年7月至2011年3月山东省济宁市第一人民医院脊柱外科收治的伴神经症状的16例胸、腰椎转移性肿瘤患者,施行后路椎管减压、瘤椎骨水泥填充、联合短节段椎弓根钉棒固定治疗。观察术后患者疼痛缓解、神经功能恢复情况及生存时间。结果围术期无死亡,切口均I期愈合,未发生感染或裂开。术后生存期均超过3个月,平均8.6个月(4.5～14.0个月)。术后患者疼痛程度、神经功能均有改善。结论椎体成形术结合后路短节段椎弓根固定治疗胸、腰椎转移性肿瘤安全、创伤小,能有效缓解患者疼痛,重建并维持脊柱稳定性,提高患者生存质量。

Objective To explore the clinical application and effects of verteborplasty combined with posterior brevi-segment fix ation with pedicle screw in the treatment of thoracolumbar spine metastatic tumor. Methods From July 2007 to March 2011,16 pa tients with tboracolumbar spinal metastatic tumor and neurological dysfunction underwent the surgical procedure of posterior spinal cord decompression and vertebroplasty combined with brevi segmental pedicle screw fixation during the same intervention. The postoperative relief of pain and the improvement of neurological recovery and live time were observed. Results There was no dead case in perioperative. All operative incision were primary healing, and were no infection and split. All patients lived more than 3 months, average was 8.6 （4.5- 14）months. Pain was relieved and neurological recovery was improved. Conclusion This kind of operation is relatively safety and it could relieve pain utility. Also it could rebuild and maintain the spinal stabilization and can effectively improve the life quality of the patients. This kind of operation is facultative for the patient with physically weak and short of expectancy life who suffered from spinal metastases.