脊柱肿瘤手术后稳定性重建与康复

目的为改善脊柱肿瘤患者的生活质量,探讨脊柱肿瘤手术后脊柱稳定性重建和术后康复的方法。方法1994/2002脊柱肿瘤患者28例,采用手术加放疗加化疗综合治疗方案并进行适当的康复功能训练。手术方式:局部姑息切除1例,局部姑息切除加前路或后路重建17例,全椎切除加前后路重建10例。结果除2例3个月死亡外,26例获6个月至6年零5个月随访,25例脊髓功能损害患者,脊髓有Frankel功能1级以上恢复,10例全椎切除后路重建病例术后恢复快,神经功能由FrankelC级恢复到FrankelE级,改善了生活质量。结论脊柱肿瘤全椎切除后前后路重建脊柱稳定性效果最理想,术后进行合理的康复训练有助于提高患者的生活质量和延长寿命。

Reconstruction of spinal stability and rehabilitation after operation of spinal tumors

Aim To explore the approach for reconstruction of spinal stability and rehabilitation for operation of spinal tumors.Methods From 1994 to 2002, twenty eight patients with spine tumors, 15 males and 13 females, aged 22-76, were treated with a surgical removal combined with radiotherapy plus chemotherapy and then adequately trained for functional rehabilitation. Surgical approaches included local palliative excision in 1 case, local palliative excision plus anterior or posterior reconstruction in 17 cases, and total spondylectomy plus anterior and posterior reconstruction in 10 cases.Results Only two patients died three months after operation. Other twenty-six patients were followed up for a period interval from 6 months to 77 months. The spinal cord functions of 25 patients who have spinal cord defects recovered to Frankel 1 level or above. The 10 cases performed total spondylectomy plus anterior and posterior reconstruction recovered faster and their nerve functions recovered from Frankel C level to E level. Life qualities were greatly improved.Conclusion The stability of anterior and posterior reconstruction following total spondylectomy is most effective. Adequate functional training is conducive to raising quality of life and prolonging life.