腰椎肿瘤全脊椎整块切除术的进展与挑战

Advances and challenges of total en bloc spondylectomy for lumbar tumors

全脊椎整块切除术(TES)的出现和应用,是脊柱肿瘤外科治疗的一个发展方向,实现了肿瘤彻底切除的边界,是脊柱肿瘤外科发展的一个里程碑。TES技术经过临床大规模应用后,在技术操作、边界研究、截骨平面、脊柱部位节段及并发症防治方面都取得了改进和进步,适应证也得到了调整,但是仍有许多尚未解决的问题和挑战,就指征、活检、术式、评分和重建等方面进行总结和展望。

Total en bloc spondylectomy (TES), which can completely remove the tumors, is a milestone and development direction for the surgical treatment of spinal tumors. Having been widely used in clinical practice, TES has made rapid progress in technical operation, margin research, osteotomy management, spinal segments and complication prevention. However, there are still issues unsolved. This study will summarize the surgical indications, biopsy, surgical methods, scoring system and reconstruction in TES, and prospect its future development.