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[1]胡钦亮,王 凯,刘凤松,等.18例经后路脊柱肿瘤切除植骨稳定性重建的疗效观察[J].天津医科大学学报,2016,22(01):51-54.
　HU Qin-liang,WANG Kai,LIU Feng-song,et al.Clinical effects of total en-bloc spondylectomy and spinal stability reconstruction on 18 patients with spinal tumors[J].Journal of Tianjin Medical University,2016,22(01):51-54.
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18例经后路脊柱肿瘤切除植骨稳定性重建的疗效观察(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
22卷
期数:
2016年01期
页码:
51-54
栏目:
临床医学
出版日期:
2016-01-20

文章信息/Info

Title:
Clinical effects of total en-bloc spondylectomy and spinal stability reconstruction on 18 patients with spinal tumors
文章编号:
1006-8147（2016）01-0051-04
作者:
胡钦亮; 王 凯; 刘凤松; 张 亮; 胡金海; 杨亚林
(天津医科大学第二医院骨科,天津 300211)
Author(s):
HU Qin-liang; WANG Kai; LIU Feng-song; ZHANG Liang; HU Jin-hai ; YANG Ya-lin
(Department of Orthopaedics, The Second Hospital, Tianjin Medical University, Tianjin 300211, China)
关键词:
脊柱肿瘤; 全椎体切除术; 整块切除术; 钛网; 椎弓根螺钉; 稳定性重建
Keywords:
spinal tumors;  stotalen-bloc spondylectomy;  Total en-bloc spondylectomy; titanium mesh; pedicle screw; spinal stability reconstruction
分类号:
R738.1
DOI:
-
文献标志码:
A
摘要:
目的：探讨经后路行全脊椎切除术治疗良恶性脊柱肿瘤的方法和近远期疗效，评价其可行性及临床价值。方法：回顾 18例肿瘤侵及椎体及附件的脊柱肿瘤患者的临床资料，所有患者均在一期经后路切除肿瘤的同时行钛网植骨融合、椎弓根钉内固定系统固定治疗。随访6～40个月，随访内容包括：手术时间、术中失血量、手术并发症、术后疼痛缓解情况、神经功能恢复情况、脊柱稳定性情况、肿瘤复发、生存时间及生活质量。结果：所有患者均获得完整随访，手术时间210～360 min；术中失血量800～1 800 mL；手术并发症2例胸椎椎体肿瘤切除术中胸膜破裂，所有切口一期愈合，无其它严重并发症；17例术前有神经功能障碍者，术后均获得显著改善；所有病例术后脊柱结构稳定；1例乳腺癌患者术后7个月复发放弃治疗，1例肾癌12个月原发肿瘤部位复发死亡，2例前列腺癌术后24个月死于多器官转移，其余患者至末次随访时脊柱稳定性良好，神经功能改善，无局部复发。结论：经后路全脊椎切除术联合植骨稳定性重建是治疗脊柱肿瘤的一种有效的手术方法，可改善神经功能、降低局部复发率，显著改善患者的生存质量 。
Abstract:
Objective：To investigate the methods and efficacy of total en-bloc spondylectomy and to evaluate its feasibility and clinical value. Methods：Review eighteen cases of spinal tumor which violated the vertebral body and attachments were reviewed. All patients underwent one-stage total en-bloc spondylectomy combined with implantation of titanium mesh filled by bone and posterior pedicle screw system via posterior approach. All cases were followed up 6 months to 40 months, which included: Operation time, surgical blood loss, operative complications, postoperative pain and neural function recovery, spinal stability conditions, tumor recurrence, survival time and quality of life. Results：All patients received complete follow-up, the operation time 210～360 min; Surgical blood loss 800～1 800 mL; 2 cases of thoracic tumor patients’pleura was ruptured in operation, while other patients had no serious complications; postoperative get significant improvementin 17 cases with neurological disabilities; All cases of postoperative have stable spinal structure; Among them, breast cancer recurred 6 months after operation（加上in one case）. One case of renal carcinoma recurred 12 months after operation. Two cases of prostatic cancer died from distant metastasis 24 months after operation. The other cases were found alive at final follow-up with good Spinal stability and no local recurrence. Conclusion: Total en-bloc spondylectomy and spinal stability reconstruction is an effective surgical treatment for spinal tumor. It can improve neurofunction, decrease local recurrence and significantly improve living quality of patients.

参考文献/References:

[1]van der Linden Y M, Dijkstra S P, Vonk E J, et al.Prediction of survival in patients with metastases in the spinal column - Results based on a randomized trial of radiotherapy[J].Cancer, 2005, 103(2):320
[2]Salame K, Regev G, Keynan O, et al. Totalen bloc spondylectomy for vertebral tumors[J].Isr Med Assoc J,2015,17(1):37
[3]Tomita K, Kawahara N, Baba H, et al. Totalen bloc spondylectomy. A new surgical technique for primary malignant vertebral tumors[J]. Spine (Phila Pa 1976),1997,22(3):324
[4]Tomita K, Kawahara N, Kobayashi T, et al. Surgical strategy for spinal metastases[J].Spine (Phila Pa 1976),2001,26(3):298
[5]王方永，李建军.脊髓损伤神经学分类国际标准(ASIA 2011版)最新修订及标准解读[J].中国康复理论与实践,2012,18(8):797
[6]Wilartratsami S, Muangsomboon S, Benjarassameroj S, et al. Prevalence of primary spinal tumors: 15-year data from Siriraj Hospital[J].J Med Assoc Thai,2014,97(Suppl 9):S83
[7]陈及非，阎作勤.全脊椎整块切除术在脊柱肿瘤治疗中的应用[J].中华骨科杂志,2008,28(2):159
[8]张铁良，王沛，马信龙，等.临床骨科学[M].北京:人民卫生出版社,2012:1820-1820
[9]Cole J S, Patchell R A. Metastatic epidural spinal cord compression[J].Lancet Neurol,2008,7(5):459
[10]Rüegg T B, Wicki A G, Aebli N, et al. The diagnostic value of magnetic resonance imaging measurements for assessing cervical spinal canal stenosis[J].J Neurosurg Spine,2015,22(3):230
[11]Liljenqvist U, Lerner T, Halm H, et al. En bloc spondylectomy in malignant tumors of the spine[J].Eur Spine J,2008,17(4):600
[12]Sakaura H, Hosono N, Mukai Y, et al.Outcome of total en bloc spondylectomy for solitary metastasis of the thoracolumbar spine[J].J Spinal Disord Tech,2004,17(4):297
[13]Fujita T, Ueda Y, Kawahara N, et al. Local spread of metastatic vertebral tumors. A histologic study[J].Spine (Phila Pa 1976), 1997,22(16):1905
[14]Fisher C G, Keynan O, Boyd M C, et al. The surgical management of primary tumorsof the spine: initial results of an ongoing prospective cohort study[J].Spine (Phila Pa 1976),2005,30(16):1899
[15]Rades D, Schild S E, Abrahm J L. Treatment of painful bone metastases[J].Nat Rev Clin Oncol,2010,7(4):220
[16]Athanasakopoulos M,Mavrogenis A F,Triantafyllopoulos G,et al. Posterior spinal fusion using pedicle screws[J].Orthopedics, 2013,36(7):e951
[17]De Bernardi B, Pianca C, Pistamiglio P, et al.Neuroblastoma with symptomatic spinal cord compression at diagnosis: Treatment and results with 76 cases[J].J Clin Oncol,2001,19(1):183
[18]Caruso J P,Cohen-Inbar O, Bilsky M H, et al. Stereotactic radiosurgery and immunotherapy for metastatic spinal melanoma[J]. Neurosurg Focus,2015,38(3)：E6
[19]毛宁方，石志才，朱晓东，等.全脊椎切除术后三种不同重建方法的稳定性比较[J].中国脊柱脊髓杂志,2007,17(6):446

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备注/Memo

备注/Memo:
作者简介 胡钦亮(1988-)，男，硕士在读，研究方向：骨科学；通信作者：王凯，E-mail：wangkaiy48@126.com。
更新日期/Last Update: 2016-01-26