一期后路全脊椎切除治疗胸腰椎恶性肿瘤的临床疗效研究

The Clinical Effect of En Bloc Spondylectomy for Thoracolumbar Spinal Malignant Tumors via Posterior Approach

目的:探讨一期后路全脊椎切除治疗胸腰椎恶性肿瘤的临床疗效。方法:将本院骨科收治的45例胸腰椎恶性肿瘤患者随机分为两组,均采用一期后路全脊椎切除治疗,其中对照组采取分块切除治疗,试验组采取整块切除治疗。比较两组患者各项手术指标及临床治疗效果。结果:45例患者手术期无1例死亡,两组患者治疗后VAS平均评分均明显低于治疗前,差异均有统计学意义(P<0.05);试验组患者平均手术时间、术中平均出血量、术中平均输血量均明显低于对照组,两组比较差异有统计学意义(P<0.05);对照组患者8例发生局部复发,5例于随访期间死亡;所有45例患者Frankel分级均有1级以上恢复。结论:一期后路全脊椎切除治疗胸腰椎恶性肿瘤安全性较高,临床疗效显著,整块切除法较分块切除法疗效更佳。

Objective：To investigate the clinical effect of en bloc spondylectomy via posterior approach for thoracolumbar spinal malignant tumors. Method：A total of 45 cases of thoracolumbar spinal malignant tumors underwent spondylectomy via posterior approach in the hospital. All the patients were randomly divided into two groups,and the control group were adopted block resection,the experimental group were taken the whole block resection. The operation indexes and clinical treatment effect were compared. Result：There was no death in operation period. The average VAS score after treatment were significantly lower than before treatment（P〈0.05）;The average operation time,intraoperative blood loss,intraoperative blood transfusion volume of experimental group patients were significantly lower than the control group（P〈0.05）;Eight cases of patients with local recurrence and 5 cases died during the follow-up in the control group;All patients had neurofunction improved at least one Frankel grade after surgery. Conclusion：En bloc via the posterior approach for the thoracolumbar spinal malignant is reliable,and the clinical curative effect is distinct. The entire block excision method block excision method curative effect is better the anther one.