钛网联合前路内固定系统对重建胸腰椎肿瘤患者脊柱稳定性及神经功能恢复的作用

背景胸腰椎肿瘤破坏椎体导致脊柱不稳及脊髓损害,肿瘤切除同时重建脊柱的稳定和患者神经功能的恢复一直为脊柱外科关注的热点.目的探讨钛网联合前路内固定系统对重建胸腰椎肿瘤患者脊柱稳定性及神经功能恢复的作用.设计前后对照研究.单位广州军区广州总医院骨科.对象2002-04/2003-11 广州军区广州总医院收治的原发胸腰椎肿瘤患者、胸腰椎转移性肿瘤患者.方法总结12例胸腰椎肿瘤切除,植骨、钛网联合前路内固定系统的方法.随访2～19个月(平均8个月).主要观察指标神经功能的恢复按Frankel分级进行观察,定期X射线观察骨融合及内固定情况.结果术后症状均有缓解,神经功能恢复优良,术后2～4周Frankel分级D级7例、E级5例.未发现内固定松动、移位现象,良好率达100%.结论钛网联合前路内固定系统应用于胸腰椎肿瘤切除后脊柱稳定重建和神经功能恢复,效果满意.

Effects of combination of titanium mesh and anterior internal fixation on reconstructing the spinal stability and rehabilitation of nerve functions to patients with thoracolumbar tumour

BACKGROUND: The thoracolumbar tumor can cause instable spine and damage spinal cord. Reconstructing the stability of spine and rehabilitating the nerve functions after excision of tumor have been attached much attention by spinal surgery.OBJECTIVE: To probe into the effects of titanic mesh combining anterior internal fixation on reconstruction of spinal stability and rehabilitation of nerve function in patients with thoracolumbar tumors.DESIGN: Before-after study.PARTICIPANTS: Patients with primary thoracolumbar tumors or metastatic tumors treated in General Hospital of Guanzhou Military Area Command of Chinese PLA during April 2002 to November 2004.METHODS: To summarize the methods of excision of tumor, bone implant and titanium mesh combining anterior internal fixation of 12 cases with thoracolumbar tumors and follow up for 2 to 19 months with mean length of 8 months.MAIN OUTCOME MEASURES: To observe the recovery of nerve functions according to Frankel' s classification and take X-ray examination to observe the bone fusion and internal fixation.RESULTS: The symptoms were alleviated after surgery and the recovery of nerve functions was good. There were 7 cases of D class and 5 cases of E class when conducting Frankel classification 2 to 4 weeks after surgery. There was no looseness and shift of internal fixation with improved rate of 100%.CONCLUSION: The effects of titanium mesh combining anterior internal fixation system on reconstructing spinal stability and rehabilitating nerve functions are satisfactory.