椎体切除术治疗脊柱肿瘤

为评价椎体切除手术治疗脊柱肿瘤的效果 ,探索提高患者生存时间和提高生活质量的方法 ,笔者回顾性总结了 1984年～2 0 0 2年 4月解放军总医院骨科有较完整随访资料的 43例椎体肿瘤切除患者的临床资料。结果发现 ,术后所有有神经压迫症状的患者症状均有缓解 ,Frankel分级平均提高 2级。3例复发行二次手术 ,1例颈椎巨细胞瘤患者术后出现短暂神经症状加重 ,1个月后恢复 ,3例患者出现术后肺部及泌尿系并发症 ;2例复发患者出现植骨吸收、塌陷 ,内固定松动。说明病变椎体切除及稳定性重建可以有效治疗某些脊柱肿瘤患者 ,如适应证选择恰当 ,配合其他辅助治疗 ,能够达到延长患者生存时间和改善患者生活质量的目的

VERTEBRAL RESECTION FOR SPINAL TUMORS

Fourty-three cases with spinal tumors treated with vertebral resection were reviewed regarding the preoperative treatment, the operations, and the results, in order to evaluate the value of resection of the vertebral body in prolonging the survival time and in improving the life quality of the patients. All the patients showed neurological recovery after surgical decompression. The average improvement was 2 grades by Frankel system. A second operation was necessary in 3 cases with recurrent lesions. Pulmonary and urinary complications were found in 3 cases. Absorption of bone grafts, collapse of vertebrae and loosening of implants were found in 2 cases. Resection of the involved tissue or segments and re-establishment of stability have become the most important treatment modality for patients with spinal tumors. With the help of adjuvant therapy, the survival time and the life quality of patients have been greatly improved.