脊柱转移癌的术前评估和手术方式评价

脊柱是恶性肿瘤骨转移最常见的部位，约占骨转移的2／3。有尸检报告显示70％的癌症患者伴有脊柱转移。其中，伴有脊髓压迫的脊柱转移癌患者占5％～14％。近年来，随着检测技术的进步，尤其是PET，CT的使用，脊柱转移癌的确诊率不断提高。在治疗方面，脊柱转移癌患者的管理理念也发生了转变，从单纯放、化疗逐渐演变为在放、化疗的基础上，积极进行外科手术治疗。试验证明，这种联合治疗比既往的单纯放、化疗对改善患者生存质量更有优势。

Preoperative assessment and evaluation of the surgical approach for spinal metastatic tumors

With the evolution of surgical techniques, extensive use of implants, and increase of the demand for higher living quality in patients, the treatment concept of spinal metastatic tumors has gradually changed in recent years. Simple chemoradiotherapy has been gradually replaced by the active surgical treatment in combination with chemoradiotherapy. Surgical treatment begins to play a more and more important role in curing spinal metastatic tumors. However, there are no unified opinions about the selections of surgical timing and surgical approach so far. How to select the reasonable surgical treatment method becomes the most difficult in curing spinal metastatic tumors. Surgeons should cautiously balance the surgical risks and the postoperative improvement of the living quality, and make a reasonable surgical assessment. This review focuses on the recent advances in the preoperative evaluation and the treatment of spinal metastatic tumors.