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时间:2020-06-04
《前后路全脊椎切除治疗下颈椎原发骨肿瘤.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、实用骨科杂志第20卷,第5期,2014年5月·401·文章编号:1008—5572(2014)05—0401—05前后路全脊椎切除治疗下颈椎原发骨肿瘤李龙,胨阳,周建伟,马华松,周雪峰,王蒙,徐唐明j(1.安徽医科大学解放军306医院临床学院,北京100101;2.解放军306医院骨科,全军脊柱外科中心,北京100101)摘要:目l的探讨前后联合入路全脊椎切除治疗下颈椎原发肿瘤的疗效。方法对我院14例下颈椎原发肿瘤采用前后联合入路全脊椎切除,前后联合内固定系统重建下颈椎稳定性。记录并比较术前、术后颈部疼痛视觉模拟评分(visu
2、alanaloguescore,VAS)、神经功能日本骨科协会(Japaneseorthopaedicassociation,JOA)评分及Franke1分级,并随访下颈椎植骨融合率。结果14例均获得随访,随访时间8~54个月。术前和术后颈部疼痛VAS评分分别为(5.43±1.60)分和(2.004-1.30)分,术后疼痛显著缓解(P<0.05)。术后神经功能改善情况按JOA评分法评估神经功能改善率(rateoftheimproveJOAscore,RIS)达63.8%。根据Frankle分级标准,术后神经功能可改善1—2级。
3、术后随访1年内植骨融合率达92.8%。结论采用前后联合入路全脊椎切除治疗下颈椎原发肿瘤,可最大可能完整切除肿瘤组织,重建下颈椎稳定性,获得满意的疗效。关键词:原发骨肿瘤;全脊椎切除;前后路中图分类号:R738.1文献标识码:BTheTotalSpondylectomyviaAnterior-posteriorApproachesintheTreatmentofLowerCerivalSpi-nalPrimaryTumorsLILong,CHENYang,ZHOUJian.wei,etal(1.Clinicalcollegein
4、306HospitalofPLA,AnhuiMedicalUniversity,Beijing100101,China;2.DepartmentofOrthopaedics,SpineCenterofPLA,the306thHospitalofPLA,Beijing100101,China)Abstract:ObjectiveToexploretheclinicalefectoftotalspondylectomyviaanterior·-posteriorapproachesinthetreat-mentoflowereer
5、ivalspinalprimarytumors.MethodsInourhospiatal,14casesoflowercervicalspinalprimarytumorsre—ceivedtotalspondylectomyviaanterior—posteriorapproaches.ThestabilityoflowercerivalspineWasreconstructedviaanteriorandposteriorinternalfixation.WerecordedandcontrastedVASscore.J
6、OAcriteriaandFrankleclassificationofallcasesbe.foreandaftersurgery.TherateoffusionWasfollowedup.Results14casesreceivedpostoperativefollow·up,rangingfrom8monthsto54months.ThepreoperativeandpostoperativeVASscorewererespectively(5.43±1.60)and(2.004-1.30).Thenervefuncti
7、onWascategorizedbyJOAcriteriaandFrankleclassification.theexcellentrateofJOAcriteriawas63.8%.Anav-erageimpovmentof1~2FranklegradeWasachievedinmostcasesaftersurgery.Therateoffusionwas92.8%after1year.ConclusionThetotalspondylectomyviaanterior-posteriorapproachesinthetr
8、eatmentoflowercerivalspinalprimarytumorscouldresectedthetumortissuecompletelyassoonaspossible,andreconstructethestabilityoflowercervicalsp
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