脊柱肿瘤切除术后稳定性重建的临床探索

目的探讨脊柱肿瘤切除术,及其重建方法的临床应用可行性。方法回顾分析我院所治疗的32例椎体肿瘤患者,其中颈椎6例,胸椎5例,腰椎17例,骶骨4例。转移性肿瘤23例,骨巨细胞瘤4例,骨髓瘤3例,恶性神经鞘瘤1例,软骨肉瘤1例。对上述患者根据病变的不同采取不同入路的肿瘤切除脊柱稳定性重建手术。结果无因手术原因而死亡的病例,无神经功能障碍加重的病例。2例出现脑脊液漏,1例内固定物松动。25例获得随访,平均随访26个月,1例因非肿瘤原因死亡,7例因广泛转移而死亡,1例术后复发后再次行肿瘤切除术。余16例近期恢复理想。结论对于脊柱肿瘤应采取积极的态度,根据病变的不同采取不同的肿瘤切除内固定手术,以最大限度的重建脊柱稳定性,恢复神经功能。

Clinical research on spinal reconstruction after tumor resection

OBJECTIVE:To study the clinical value of spinal reconstruction after tumor resection. METHODS: Thirty-two patients with spinal tumor (19 males and 13 females with the mean age of 47.6 years old) underwent tumor resection and spinal reconstruction. There were 6 in cervical, 5 in thoracia, 17 in lumbar and 4 in sacrum, and 23 patients with metastasis tumor, 4 with the giant cell tumor of bone, 3 with myeloma and 1 with malignant schwannoma, 1 with chondrosarcoma. Different methods of tumor resection and spinal reconstruction were ptrformed according to the different lesion locations. RESULTS: No patient died from operation. Twenty-five patients were followed-up with the mean time of 26 months. One died from the non-tumor reason, 7 patients died of metastasis. CONCLUSION: For spinal tumor, in order to reconstruct the spinal stabilization and recover the nervous function, resection and spinal reconstruction operation should be performed according to the different lesions and different locations.