脊柱转移瘤手术并发症研究进展

Research progress of surgical complications of spinal metastasis

脊柱转移瘤是恶性肿瘤的严重并发症,随着肿瘤患者生存率改善,脊柱转移瘤发生率不断提升。减压手术联合术后放疗能明显改善患者的功能预后和生存质量,因此与单纯放疗相比,减压手术联合术后放疗已成为脊柱转移瘤患者的优先治疗选择。然而,手术并发症仍是一个严峻的问题。依据并发症出现的时间节点可以分为术中并发症、术后并发症。术中并发症主要包括脊髓神经损伤、脑脊液漏、血管损伤以及周围器官损伤等;术后并发症主要包括内固定失败、手术切口感染、脊柱不稳和假关节形成、肿瘤局部复发以及其他系统性并发症。本综述将对脊柱转移瘤的手术并发症以及相关风险因素进行阐述与介绍,以期为预防与避免脊柱转移瘤手术并发症的发生提供参考依据。

Spinal metastasis is a serious complication of malignant tumors.With the improvement of survival rate,the incidence of spinal metastasis is increasing.Decompressive surgery combined with postoperative radiotherapy can significantly improve the functional prognosis and quality of life of patients,therefore decompressive surgery combined with postoperative radiotherapy has become a priority treatment option for patients with spinal metastasis,as compared with radiotherapy alone.However,surgical complications are still a serious problem.According to the occurrence time of complications,complications can be divided into intraoperative complications and postoperative complications.Intraoperative complications mainly include spinal cord nerve injury,cerebrospinal fluid leakage,vascular injury and peripheral organ injury and so on.Postoperative complications mainly include failure of internal fixation,infection of surgical incision instability,pseudoarthrosis,local recurrence of tumor and other systemic complications.This review will introduce the surgical complications and related risk factors of spinal metastases,in order to provide reference and basis for preventing and avoiding the complications of spinal metastases.