单纯后路保留骶神经骶骨分块切除治疗原发性骶骨肿瘤

Sacral piecemeal resection with nerve-sparing via posterior-only approach for primary sacral tumor

目的 探讨单纯后路保留骶神经骶骨分块切除治疗原发性骶骨肿瘤的疗效。方法 回顾性分析我院采用单纯后路骶骨分块切除术治疗的23例原发性骶骨肿瘤患者的临床资料,患者术中尽可能保留骶神经,且均进行髂腰重建。采用视觉模拟量表(VAS)评分评估患者手术前后的疼痛程度。采用骶神经功能评分评估患者手术前后的神经功能。结果 23例患者均顺利完成手术,手术时间为(277.96±77.23)min,术中出血量为(1 382.61±1 163.32)mL。所有患者均获得随访,随访时间(37.43±24.48)个月。患者术前与术后1个月骶神经功能评分及VAS评分比较,差异具有统计学意义(P<0.05);术前与末次随访时骶神经功能评分比较,差异无统计学意义(P>0.05),VAS评分比较,差异有统计学意义(P<0.05)。结论 单纯后路骶骨分块切除术能够在切除肿瘤的基础上,尽可能更多地保留骶神经,提高患者术后生活质量。

Objective To investigate the efficacy of sacral piecemeal resection with nerve-sparing via posterior-only approach for primary sacral tumor.Methods The clinical data of 23 patients with primary sacral tumor treated by sacral piecemeal resection via posterior-only approach in our hospital were retrospectively analyzed.The sacral nerves were preserved as much as possible during the operation,and all patients underwent iliolumbar reconstruction.The visual analogue scale (VAS) score was used to evaluate the degree of pain of patients before and after operation.The sacral nerve function score was used to evaluate the nerve function of patients before and after operation.Results All the 23 patients successfully completed the operation,with the operative time of (277.96±77.23) minutes and the intraopera-tive blood loss of (1 382.61±1 163.32) mL.All patients were followed up for (37.43±24.48) months.There were statistically significant differences in the sacral nerve function score and VAS score of the patients before operation and 1 month after operation (P<0.05).There was no statistically significant difference in the sacral nerve function score of the patients before operation and at the last follow-up (P>0.05),while there was statistically significant difference in the VAS score(P<0.05).Conclusion Sacral piecemeal resection via posterior-only approach can preserve the sacral nerve as much as possible and improve the quality of life of patients after operation on the basis of completely tumor resection.