腰椎骨盆内固定重建术对骶骨肿瘤的作用评价

Effective Evaluation of Reconstruction of Lumbo-sacral Internal Fixat ion on Sacral Tumors

目的 :探讨骶骨肿瘤切除术后腰椎与骨盆TSRH内固定重建方法及其作用。方法 :本院于 1 998年 1 2月～2 0 0 1年 1 2月 ,收治 35例腰骶段骨肿瘤患者 ,其中原发性肿瘤 32例 ,转移癌 3例 ,L5～S1 3例 ,L5～S2 2例 ,L5～S31例 ,S1 3例 ,S1～ 2 7例 ,S1～ 36例 ,S1～ 4 5例 ,S1～ 54例 ,S2～ 4 2例 ,S2～ 53例。肿瘤切除术后给予腰椎与骨盆TSRH内固定术 35例 ,并给予相应的放疗与化疗。结果 :术后随访 6～ 43个月 ,1例术后出现排尿困难 ,2例术后出现脑脊液瘘 ,1例术后切口感染及延期愈合 ,术后近期疗效均较满意 ,患者腰骶部疼痛及神经功能有不同程度改善 ,1例软骨肉瘤患者于术后 1年复发 ,2例转移癌患者分别于术后 1 4个月、2 0个月因全身衰竭而死亡 ,未发生断钉断棒。结论 :骶骨肿瘤切除与重建术后有利于保持腰椎及骨盆的稳定性 ,能够更好地减轻疼痛 。

Objective:In order to investigate the way of r esection of sacrum tumors and the way and duration of the spinal-pelvic TSRH in ternal fixation.Method:From Dec 1998 to Dec 2001,35 cases with sacral tumor wer e enrolled in our hospital,including 32 cases with primary tumors and 3 with metas tasis cancers,and with 3 cases involving in L 5～S 1,2 in L 5～S 2,1 in L 5～S 3,3 in S 1,7 in S 1～2 ,6 in S 1～3 ,5 in S 1～4 ,4 in S 1～5 ,2 in S 2～4 and 3 in S 2～5 .All cases were followed by lu mb o-pelvic TSRH internal fixation and corresponding chemotherapy and radiotherapy . Results:In the follow-up period of 6～43 months,the results of short-term were satisfactory with the lumbosacral pain reduced and the neurological function im proved in different degrees,other 2 cases experienced cerebrospinal fluid l eakage and 1 case experienced perative infection and delayed healing.1 case with chondrosarcoma recurred 1 year after operation and 2 cases with metast asis cancer died of exhaustion 14 and 26 months respectively.No fracture rod oc cu rred.Conclusion:Lumbosacral tumor resection and reconstruction are effective mea ns of achieving stabilization,providing significant pain relief and preserving a mbulatory capacity.