选择性动脉栓塞在胸、腰段脊柱肿瘤治疗中的应用

目的 探讨减少脊柱肿瘤切除术中出血及提高肿瘤切除彻底性的有效方法。方法 １９８４年６月～１９９７年４月对１５例胸,腰段原发脊柱肿瘤（巨细胞瘤５例,恶性神经鞘瘤２例,脊索瘤１例,纤维黄色瘤１例,恶性纤维组织细胞瘤１例,骨母细胞型骨肉瘤１例,Ｅｗｉｎｇ肉瘤１例,骨髓瘤１例,平滑肌肉瘤１例,非何杰金氏淋巴瘤１例）术前彩 选择性节段性动脉栓塞,术中行病灶切除及脊椎重 中８例采用一期椎体全切除,结果 栓塞满

Selective arterial embolization for the treatment of thoracolumbar spinal tumor

Objective To decrease intraoperative blood loss during tumor resection. Methods Fifteen patients with primary thoraco lumbar spinal tumor [giant cell tumor (5 patients), malignant nerinoma (2), chordoma (1), fibrous xanthosarcoma(1),malignant fibrohistocytoma(1), osteosarcoma(1), Ewing sarcoma(1), myeloma(1), leimyosarcoma(1), Non Hodgkin diseases (1)] were treated by means of preoperative selective arterial embolization, tumor resection, and spinal reconstruction. Eight patients were subjected to total spondeylectomy in one stage. Results Fourteen patients showed satisfactory results after embolization. The volume of intraoperative blood loss ranged from 3?000?ml to 400?ml (average 1?200 ml). Follow up of the patients varied from 8 months to 19 years (average 48 7 months). Local recurrence happened in 3 patients; 3 patients died from metastasis. Three of 4 patients recovered from complete bowel movement and urination. Sevent of nine patients had musical strength improved. Six of 8 patients had recovery of the e sensation of the lower limbs. Conclusions Selective arterial embolization before operation followed by operation within 24 hours can reduce intraoperative blood loss, shorten operative time, and provide a clear operative field for tumor resection.