椎弓根钉内固定治疗胸腰椎恶性肿瘤

目的观察、评估椎弓根钉内固定在治疗胸腰椎恶性肿瘤中的结果及意义。方法对1996年2月-2003年2月应用椎弓根内固定系统治疗的脊柱恶性肿瘤19例的结果、生存时间、并发症进行分析，与有关文献资料进行比较。结果19例中17例(89．5％)疼痛缓解或明显减轻；14例截瘫患者中10例(71．4％)术后神经症状好转，4例术后截瘫加重，但之后逐渐恢复。结论脊柱内固定、姑息性切除肿瘤及神经减压可起到缓解疼痛、改善神经症状的作用，且有利于患者术后早期活动进行康复训练，提高生存质量，防止并发症发生，延长生存时阃。椎弓根钉内固定是一种安全、有效的重建脊柱稳定性的方法。

Significance of Transpedicular Fixation in Treatment of Malignancies at Thoracic and Lumbar Spine

Objective To observe and evaluate the outcome and significance of transpedicular screw fixation in treatment of malignant tumor at thoracic and lumbar spine.Methods From February 1996 to February 2003,19 patients with malignant tumors in thoracic and lumbar spine were treated by pedicle screw instrumentation,the outcome,including relieve of pain,recovery of neurological function,survival of life and complications was analyzed and compared with other data.Results 17 out of 19 patients achieved relieve of pain after surgery(89.5%),neurological improvement was observed in 10 cases among 14 cases(71.4%) after decompression and posterior stabilization,paraplegia aggravated in 4 cases.Conclusion The data obtained in this study suggested that stabilization of spine,palliative resection of tumor and spinal cord decompression could significantly relieve the pain and improve the neurological function.The internal fixation also might enable the patients to move earlier,therefore improve the survival quality,prevent complication and prolonged the survival time.The pedicle screw fixation is a safe and effective treatment for patients with spinal malignancies to reconstruct their spinal stability.