钛网内固定系统重建胸腰段肿瘤切除后脊柱:稳定性及生物相容性

Thoracolumbar spinal reconstruction with titanium mesh implantation combined with internal fixation after tumor resection:stability and biocompatibility

背景:脊柱胸腰段肿瘤切除后会对脊柱的稳定性产生较大的影响,临床需要积极的进行内固定,以维持良好的脊柱稳定性。利用钛网植入联合内固定的方式,可以为肿瘤切除后提供坚强内固定。目的:观察钛网内固定系统重建脊柱胸腰段肿瘤切除后的脊柱稳定性及与宿主的生物相容性。方法:从遂宁市中心医院2012年9月至2014年9月收治的脊柱胸腰段肿瘤患者中随机选择24例进行研究,均实施肿瘤切除治疗,并联合予以钛网植骨植入缺损区+前路内固定。治疗后随访1-12个月,观察患者的神经功能恢复情况及脊柱稳定性,并进行分析。结果与结论:入组的24例脊柱胸腰段肿瘤患者均顺利完成治疗,至随访结束未出现死亡病例。患者的临床症状和神经功能均得到显著缓解,治疗前后Frankel分级情况得到显著改善。且经定期X射线片检查,24例患者的钛网及前路内固定系统位置均未出现改变,且未出现钛网塌陷、内固定断裂松动等情况,脊柱稳定性良好。表明脊柱胸腰段肿瘤切除联合钛网植入+前路内固定可以重建脊柱稳定性,获得良好的临床效果,且生物相容性好。

BACKGROUND：Clinical resection of thoracolumbar spinal tumor has a great impact on the spinal stability. Positive internal fixation is required clinicaly in order to maintain the spinal stability. The use of titanium mesh implantation can provide a firm internal fixation folowing resection of tumors. OBJECTIVE：To explore the spinal stability undergoing titanium mesh implantation with internal fixation folowing thoracolumbar tumor resection. METHODS：Twenty-four patients with thoracolumbar tumor admitted at the Central Hospital of Suining City from September 2013 to September 2014 were randomly selected and given tumor resection folowed by titanium mesh implantation with internal fixation. After treatment, patients were folowed up for 1-12 months to observe and analyze the neural functional recovery and spinal stability of the patients. RESULTS AND CONCLUSION：Al the 24 patients successfuly completed the operation treatment, and there was no case of death at the end of folow-up. During the folow-up, patient＇s clinical symptoms and neural function were significantly relieved, and Frankel classification was significantly improved after treatment. Regular X-ray examination showed that there was no change in the position of titanium mesh and anterior internal fixation system. There was also no titanium mesh colapse, internal fixation fracture and loosening, and the spinal stability was stil excelent. These findings indicate that patients were not changed, and did not appear because the amount of loose, good spinal stability. Resection of thoracolumbar tumors showed that the thoracolumbar spinal reconstruction with titanium mesh implantation combined with internal fixation folowing tumor resection can obtain good clinical effect and excelent biocompatiblity.