脊柱转移瘤的外科治疗效果

目的：探讨脊柱转移瘤患者手术治疗的适应证与疗效。方法：对1998年7月至2003年7月5年间收治的167例脊柱转移瘤患者的临床资料进行回顾性分析。胸椎转移99例，腰椎转移53例．颈椎转移15例。男性96例，女性71例。出现神经系统受损者112例，其中Frankel分级A级17例．B级11例．C级22例．D级62例。患者均有不同程度的疼痛，手术根据肿瘤破坏脊椎的部位行前路椎体切除、钢板内固定术或后路病变椎板切除、肿瘤切除、椎管减压、经椎弓根内固定术。结果：167例患者中，155例（92．8％）术后疼痛得到缓解。112例有神经功能损害的患中，67例（59．8％）术后Frankel分级有不同程度的改善。随访6～48个月．术后存活1年以上的患者117例，约占患者总数的70％。结论：由于转移瘤所致椎体塌陷或不稳定造成严重的神经损害或机械性不稳脊柱痛疼的患者，手术治疗可改善其神经功能，增加脊椎稳定性．提高生存质量。

Surgical treatment of metastatic spinal tumors

Objective:To evaluate the indication and results of surgical treatment of metastatic spinal tumors.Method:From 1998 to 2003,167 patients(71 women and 96 men)with metastatic spinal tumors accepted surgical treatment.Of those patients,99 had thoracic spine involved,53 had lumbar spine involved,15 had cervical spine involved.Among 112 of 167 patients who presented with neurological dysfunction,17 patients were classified in grade A,11 in B,22 in C and 62 in D according to the system of Frankel.All patients were performed with surgical intervention by anterior or poterior approach.Result:All patients were followed up for 6 to 48 months.Pain relief was obtained in 155 of 167 patients(92.8%)and neurological improvement was obtained in 67 of the 112 patients(59.8%).The over all one-year survival rate was 70%(117 cases).Conclusion:For patients with spinal instability and neurological deficit due to spinal metastatic tumor,surgical treatment can possess good outcome.