瘤椎全切及脊柱稳定性重建治疗胸腰椎肿瘤17例

目的:探讨瘤椎全切与脊柱稳定性重建治疗胸腰椎肿瘤的手术方法及临床疗效。方法:对17例椎体及附件结构不同程度遭破坏的胸腰椎肿瘤患者采用瘤椎切除及内固定重建技术进行治疗。其中包括骨巨细胞瘤4例,孤立性浆细胞瘤2例,软骨肉瘤2例,转移性骨肿瘤9例。有12例病患伴有不同程度的神经功能障碍。结果:经6～24个月的随访,1例转移性骨肿瘤患者于术后7个月死亡;另1例转移性骨肿瘤患者出现了其他部位的转移并放弃了治疗,未能随访;余下病例的胸背痛及腰腿痛症状均有所缓解,神经功能障碍均有不同程度的恢复。结论:瘤椎切除及脊柱稳定性重建是治疗胸腰椎原发性肿瘤的主要方法,而对于原发病灶已得到控制的转移性骨肿瘤,也是提高病患的生活质量,减轻痛苦,延长生命的有效方法。

Objective:surgical method and clinical effect on the total thoracic and lumbar vertebrae tumors resection and the spinal reconstruction to building vertebral stability.Methods:for treatment of 17 cases of thoracic lumbar vertebral and its accessories in different degrees of the structure damaged by tumors to spinal reconstructions.Including 4 cases of bone giant cell tumors,2 cases of isolated plasma cell tumors,2 cases of chondrosarcoma,9 cases of metastatic bone tumor.12 patients with different levels of nerve dysfunction.Results:after 6-24 months following,1 case with metastatic bone tumors after seven months death,another case with metastatic bone tumors appear in other parts of the transferring and abandoned the treatment,failed the following,The chest pain and lumber-leg pain of others are mitigated,the nerve dysfunction of the patients are different degree of recovery.Conclusion:tumor resection and reconstruction of vertebral spinal stability is the primary treatment and a effective methods to prolong life alleviating the pain and improving the quality of life of the patients with spinal tumours,also the primary lesion of the bones cancer metastases has been get controlled.