脊柱骨髓瘤的诊断与治疗

目的:探讨脊柱骨髓瘤的诊断方法与治疗效果。方法:回顾性分析1993～2001年收治的14例脊柱骨髓瘤患者的资料,13例行脊椎活检,其中经皮穿刺活检12例,切开活检1例,另1例行术中病理检查。病理报告均为骨髓瘤。孤立性骨髓瘤9例,多发骨髓瘤5例。10例行手术治疗。结果:8例手术患者获15～102个月(平均37.6个月)随访,7例存活。未手术的4例中1例无瘤存活76个月,另3例分别于确诊后6、18和25个月死亡。结论:经皮脊椎穿刺活检是确诊脊柱骨髓瘤的重要手段,选择性手术结合放疗及化疗可稳定脊柱、解除脊髓压迫、提高患者生活质量。

Diagnosis and surgical treatment of the spinal myeloma

Objective:To evaluate the diagnosis and surgical treatment of spinal myeloma. Method:To review the clinical records of 14 consecutive patients diagnosed as myeloma of the spine from 1993 to 2001.Result:Twelve patients had CT-guided percutaneous needle puncture biopsy and were diagnosed as myeloma.Nine cases were solitary myeloma and 5 were multiple.Ten patients underwent surgical procedures,8 were followed for an average 37.6 months,seven of them are still alive.In the four non-operated patients,one was alive within 76 months,the others were died in 6,18 and 25 months after diagnosis,respectively.Conclusion:CT-guided percutaneous biopsy is valuable in the diagnosis of spinal myeloma.The surgical treatment of myeloma of the spine seems to be an effective method with respect to neurologic function and spine stability.