肿瘤切除腰椎骨盆稳定性重建术治疗骶骨脊索瘤

目的：探讨肿瘤切除腰椎骨盆稳定性重建术治疗骶骨脊索瘤的临床意义。方法：回顾性，分析2003年8月至2011年8月，采用肿瘤切除腰椎骨盆稳定性重建术治疗骶骨脊索瘤78例，其中男性58例、女性20例，年龄27—79岁。根据术前肿瘤学评估，56例行单纯后路手术，22例行前后联合人路手术；术后分别行化疗、放疗、抑制骨溶解治疗、生物靶向治疗等综合治疗。结果：所有患者无手术死亡，术后骶尾部疼痛改善明显。术后病理诊断典型脊索瘤76例，去分化脊索瘤2例。术后均获随访4～85个月，平均40个月。32例于术后3～67个月局部复发，平均复发时间25个月。7例因复发及远处转移分别于术后17、18、22、27、30、33及69个月死亡。结论：肿瘤切除腰椎骨盆稳定性重建术是外科治疗骶骨脊索瘤的有效方法。

Treatment of Sacral Chordoma by Posterior Lumbopelvic Stability Reconstruction

Objective ：To study the clinical significance of an posterior lumbopelvic stability reconstruction for sacral chordoma resection. Methods： The characteristics of 78 patients （58 males and 20 females with an average age of 56 years） with sacral chordoma received from August 2003 to August 2011 were retrospectively analyzed. All of the patients were treated by lumbopelvic stability reconstruction with sacral tumor resection. According to the preoperative oncological assessment,56 patients received posterior approach surgery alone and the other 22 patients were treated with anterior and posterior approach surgery. Chemotherapy, radiotherapy, inhibition of osteolysis treatment and biological target therapy were applied selectively in postoperative. Results： No patients died in the operation and the sacrococcygeal pain of 78 cases was relieved after surgery. 76 cases were the typical chordoma and 2 were the differentiation chordoma. The mean follow - up was 40 months （4 - 85 months）. 32 of 78 cases recurred. The average recurrence time was 25 months （3 - 67 months）. 7 cases died of recurrence and distant metastasis in 17,18,22,27,30,33 and 69 months after operation. Conclusions ： Lum- bopelvic stability reconstruction with sacral tumor resection is an effective method on sacral chordoma.