颈椎转移性骨肿瘤的手术治疗

目的：探讨颈椎转移性骨肿瘤的临床表现和治疗等。方法：对29例患者（枢椎3例，下颈椎26例）的临床表现，手术适应证，外科治疗进行分析，结果：术后随访6个月－5年，1例枢椎肿瘤术后症状无改善，呼吸衰竭死亡；25例术后局部疼痛，神经根痛缓解甚至消失，神经压迫症状改善或缓解；3例患者分别于13、19、25个月后因全身多处转移、衰竭死亡，结论：颈椎转移必骨肿瘤多数患者表现为疼痛，部分患者有神经损害的表现，手术必须考虑全身情况，限于颈椎不稳，神经功能进行性损害，疼痛剧烈，或原发灶不明，手术作为明确病理诊断以指导进一步治疗的患者，根据肿瘤侵犯悦位，患者耐受手术情况，预期寿命等选择前路，后路或前后路的一期或二期手术，手术能够稳定和重建颈椎减轻或消除患者的疼痛，维持或改善神经功能，从而改善患者的生活质量。

Surgical Treatment of the Metastatic Osteo-Neoplasma in the Cervical Spine

Objective: To study the clinical presentations, surgical indications and approaches, and the clinical results of the cervical metastatic Osteo-neoplasma. Methods: In this group there were 29 patients including 3 with axis tumors and 26 with lower cervical tumors. The patients underwent anterior, posterior, combined or staged anteroposterior operations based on the location of tumor lesions in the cervical spine. Results: The postoperative follow-up ranged from 6 months to 5 years. One patient died ten days after operation as a result of tetraplegia. The other 28 cases had partial or even complete relief local pain and radiculopathy and improvement of neurological status. Three patients died because of multiple metastases and systemic failure 13,19 and 25 months later, respectively. Conclusions: Pain was the predominant symptom. The surgical indication for the cervical metastatic diseases includes cervical spine instability, progressive neurological deterioration, intractable pain, or the need for histological diagnosis. Surgical intervention can stabilize and reconstruct the cervical spine, relieve pain, maintain or improve the neurological status of the patients, thus improving the life qualities in these limited life expectancy patients.