临床医学论文经胸椎体切除术治疗脊柱转移瘤.doc

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1、临床医学论文-经胸椎体切除术治疗脊柱转移瘤作者：常增林崔新广刘近举青光恒李锋【关键词】肿瘤转移摘要：〔冃的〕探讨经胸椎体切除术、前路内固定系统重建脊柱稳定治疗胸椎转移瘤的临床效果。〔方法〕回顾性分析21例胸椎转移瘤患者采用经胸椎体切除、单纯植骨支撑融合或钛网支撑植骨融合、载抗肿瘤药骨水泥应用及前路内固定重建技术的治疗效果。男13例，女8例；年龄32〜68岁，平均485岁，主要原发瘤包括肺癌6例，肾癌5例，乳腺癌5例，其它肿瘤5例，最常见的临床表现是背痛20例，下肢无力10例，下肢不全瘫伴感觉及腱反射异常8例，1例全瘫。〔结果〕所有病例获得完整随访，随访时间6〜56个

2、月、平均24个月。15例患者疼痛缓解，10例术前双下肢无力但能行走的患者中，术后完全恢复正常；9例术前不能行走的患者中，术后6例能够行走，3例行走未恢复，但神经功能有明显改善。肿瘤局部复发5例，复发率238%。〔结论〕经胸椎体切除、前路内固定系统重建术治疗胸椎转移瘤能够明显改善患者的生存质量，恢复或保护患者的运动功能，控制顽固的脊柱疼痛。关键词：脊柱；肿瘤转移；椎体切除；治疗结果TransthoracicvetebrectomyformetastaticspinaltumorsAbstract:[Objective]Toevaluatetheclinicalresu

3、ltsforpatientswithmetastaticspinaltumorstreatedbymeansofanteriorvertebralbodyresection,reconstruetion,andstabi1ization〔Method〕Twentyonepatientswithmetastaticspinaltumorsweretreatedbymeansofanteriorvertebralbodyresection,decompression,reconstruetionwithanadriamycinbonecementpackedTimesh

4、cageorribstrutgraft,andanteriorfixationwithlockingplateandscrewconstruction,al1caseswereanalyzedretrospectivelyTherewere13malesand8femaleswiththeaverageageof485yearsold(ranged,32~68years)Thepredominantprimarytumorsincludedlungcancerin6patients,rencilcancerin5,breastcancerin5,andothersi

5、n5Themostcommonpresentingsymptomswerebackpainin20patients,incompletelyparalysisin8patients,completeparalysisinonepatients〔Result〕Aftersurgery,al1patientswerereviewedThemeanfollowupperiodwas24months(ranged,6〜56months)Paindecreasedin15ofal120palienlsTenpatientswhohadlow1imbsweaknessbutco

6、uldambulateprcopcrativelyregainednormalstrengthinthe9patientswithoutambulatoryabi1ity,6couldwa1kaftersurgeryand3werestillunabletowa1kbutshowedimprovedmotorfunctionTumorreoccurredin5cases[Conclusion]11suggeststhattransthoracicvertebrectomyandspinalstabi1izationcanimprovelhequalityofdail

7、y1ifeconsiderablyincancerpatientswithspinalmetastasis,itcansignificantlyrelievepain,maintainorimprovetheneurologicalstatusKeywords:Spine;Neoplasmmetastasis;Vertebrectomy;Treatmentoutcome胸椎转移瘤是最常见的脊柱转移瘤，患者除表现有顽固性迸行性加重的疼痛外，一部分患者还伴有不同程度的神经功能损害，病理性骨折或截瘫，严重影响了患者的生活质量。随着内固定植入器械的发展，胸椎转移瘤的治疗