脊柱转移瘤的外科处理(附22例报告)

目的 脊柱转移瘤可引起顽固性疼痛及脊髓压迫，探讨其外科治疗的临床效果。方法 回顾性分析1995～2003年手术治疗22例脊柱转移瘤患者的临床资料。结果 术后22例疼痛均得到缓解。14例有神经功能损害者术后麻痹症状得到不同程度的改善；8例术前膀胱或(和)直肠功能受损的患者中，术后除2例变化不明显外。余6例膀胱与直肠功能明显改善；术前4例Frankel A级患者，1例无变化，2例术后恢复至C级，1例恢复至D级；6例C级患者中3例恢复至D级，3例恢复至E级，4例D级患者全部恢复至E级。结论 积极的手术治疗可以缓解疼痛、解除压迫、重建脊柱的稳定性，进而改善患者的生活质量。

Surgical treatment of metastatic spinal tumors

Objective Patients with metastatic spinal tumors often suffered from severe back pain,spinal cord compression directly caused by tumor tissue and severe spinal kyphosis.In order to treat or prevent spinal cord paralysis,decompression and instrumentation should be performed on patients with spinal pain and(or) spinal cord compression.Method Clinical data of 22 patients with metastatic tumors were retrospectively evaluated from 1995 through 2003.Results Pain were reduced in all patients.Different neurological function recoveries were got in 14 cases with neurological defect.2 in 8 cases with bowel and bladder dysfunction remained unchanged,other 6 cases improved obviously.Among 4 cases of preoperative Frankel grade A,1 case remained unchanged,1 restored to C grade,1 to D grade.Among 6 cases evaluated as C grade,3 restored to D,3 to E.4 cases evaluated as D grade restored to E grade.Conclusions Aggressive surgical treatment can relieve pain,remove compression,reconstruct the spinal stability,and subsequently improve the life of patients.