整块切除术治疗孤立性脊柱转移瘤的疗效

目的 评估孤立性脊柱转移瘤患者接受脊柱肿瘤整块切除术（en bloc spondylectomy）治疗的近期临床疗效及预后。 方法 回顾性分析2017年1月至2019年9月于本院接受en bloc切除术治疗的孤立性脊椎转移瘤患者资料，收集患者性别、年龄、病灶部位、原发肿瘤类型、术中出血量和术后并发症发生情况，以及术前和术后的Frankel神经功能评分和KPS功能状态评分。每3个月随访1次，评估患者局部无进展生存期（progression-free survival，PFS）和总生存期（overall survival，OS）。结果 共28例患者纳入本研究，男性17例，女性11例。平均手术时间（5.78±0.33） h （范围：4.0~7.5 h），平均术中出血量（1 867.21±613.84） mL（范围：900~3 000 mL）；术后发生脑脊液漏6例，局部感染5例，其中感染病例中有3例为脑脊液漏患者，均经治疗后恢复。术后KPS评分和Frankel评分较术前均显著改善（均P<0.05）。中位随访时间为15个月（范围：6~33个月），1年和2年局部无进展生存率分别为87.1%与68.8%，1年和2年总生存率分别为72.5%与42.3%。结论 脊柱肿瘤整块切除术是一种安全有效的治疗孤立性脊柱转移瘤的方式，术后并发症发生率较低，局部控制率良好，生活质量明显改善。

Surgical outcomes of en bloc spondylectomy for solitary spinal metastasis

Objective To evaluate the short-term clinical efficacy and prognosis of patients with solitary spinal metastases who received en bloc spondylectomy(en bloc). Methods The clinical data of patients with solitary spinal metastasis,  who received en bloc resection in our hospital between January 2017 and September 2019,  were analyzed retrospectively,  including the gender,  age,  lesion location,  primary tumor type,  intraoperative bleeding,  and postoperative surgery complications,  as well as the Frankel neurological function score and KPS functional status score before and after surgery. All patients were followed up every 3 months to assess the local progression-free survival (PFS) and overall survival (OS). Results A total of 28 patients were included in this study,  including 17 male and 11 female. The average operation time was (5.78±0.33) h (range: 4.0-7.5 h),  and the average intraoperative blood loss was (1 867.21±613.84) mL (range: 900-3000 mL); 6 cases of postoperative cerebrospinal fluid leakage and 5 cases of local infection occurred after surgery,  of which 3 cases of infection were patients with cerebrospinal fluid leakage,  and all recovered after treatment. The KPS score and Frankel score were significantly improved after the surgery(all P<0.05). The median follow-up time was 15 months (6-33 months),  the 1-year and 2-year local PFS were 87.1% and 68.8%,  respectively,  and the 1-year and 2-year OS were 72.5% and 42.3%,  respectively. Conclusion En bloc resection is a safe and effective way to treat solitary spinal metastases,  with a low incidence of postoperative complications,  good local control rate,  and a significant improvement in the quality of life.