Anterior Approaches with Vertebrectomy followed by Spinal Stabilization for Patients with Metastatic Thoracic Disease_West China Medical Journal

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Department of Orthopaedics , West China Hospital of Sichuan University , Chengdu 610041 , China;

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Keywords：

前路手术; 胸椎; 转移瘤

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目的:探讨前路手术治疗胸椎转移瘤的临床疗效、手术方法及手术适应证。方法:2003年11月至2005年11月收治胸椎转移瘤38例,男21例,女17例;所有患者均伴有不同程度疼痛,伴神经功能障碍29例。结果:术后随访6个月,患者疼痛均有不同程度缓解, 视觉类比评分(VAS)由术前平均7.13降至术后平均1.71。术后患者使用止痛药的级别和用量均明显下降,其中多数患者(15例)无需再使用止痛药。伴神经功能障碍29例患者中,术后27例有改善,其中2例Frankel C级和9例Frankel D级患者感觉、运动基本恢复正常。局部肿瘤无复发,内固定器无松动断裂。结论:前路手术治疗胸椎转移瘤可以充分显露病灶, 有利于减压以及重建脊柱稳定性,从而有效控制疼痛、防治神经功能损害,提高生存质量。

Citation： XUAN Jing,SONG Yueming,LIU Hao,et al. Anterior Approaches with Vertebrectomy followed by Spinal Stabilization for Patients with Metastatic Thoracic Disease. West China Medical Journal, 2009, 24(6): 1390-1393. doi: Copy

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9.	JANJAN NA. Radiation for bone metastases: conventional techniques and the role of systemic radiopharmaceuticals [J]. Cancer, 1997,80:1628-1645.
10.	YOUNG RF, POST EM, KING GA. Treatment of spinal epidural metastases:randomized prospective comparison of laminectomy and radiotherapy [J]. J Neurosurg, 1980, 53:741-748.
11.	JANJAN NA. Radiation for bone metastases: conventional techniques and the role of systemic radiopharmaceuticals [J]. Cancer, 1997,80:1628-1645.
12.	BYRNE TN. Spinal cord compression from epidural metastases [J]. N Engl J Med, 1992, 327: 614619.
13.	LOBLAW DA, PERRY J, CHAMBERS A, LAPERRIERE NJ. Systematic review of the diagnosis and management of malignant extradural spinal cord compression [J].J Clin Oncol,2005, 23: 2028-2037.
14.	DOPPMAN JL, GIRTON RT. Angiographic study of the effect of laminectomy in the presence of acute anterior epidural masses [J].J Neurosurg, 1976,45:195-202.
15.	KANAYAMA M, NG JT, CUNNINGHAM BW, et al. Biomechanical analysis of anterior versus circumferential spinal reconstruction for various anatomic stages of tumor lesions [J].Spine,1999,24: 445-450.
16.	SANMILLAN RUIZD, BURKHARDT K, JEAN B, et al. Pathology findings with acrylic imp lants [J].Bone, 1999, 25 (2 Supp l): 85-90.

1. AARON AD. The management of cancer metastatic to bone [J]. JAMA,1994,272: 1206-1209.
2. COBB CA, et al. Indications for nonoperative treatment of spinal cord compression due to breast cancer [J].Neurosurg,1977,47: 653-658.
3. WONG DA, et al. Spinal metastases: the obvious, the occult, and the imposters [J].Spine, 1990,15: 1-4.
4. SUNDARESAN N, et al. Metastatic tumors of the spine. In Tumors of the Spine: Diagnosis and Clinical Management, 1990,279-304 Philadelphia: WB Saunders..
5. GOKASALAN ZL, YORK JE, WALSH GL, et al. Transthoracic vertebrectomy for metastatic spinal tumors [J].J Neurosurg, 1998,89:599-609.
6. 曾建成, 宋跃明, 刘浩, 等. 瘤椎全切与重建治疗胸腰椎肿瘤伴神经功能障碍[J].中国修复重建外科杂志, 2007,21(5):445-448.
7. TOKUHASH I Y, M ATSUZAK I H, ODA H, et al. A revised sco ring system fo r p reoperative evaluation of metastatic sp ine tumo r p rognosis [J]. Spine, 2005, 30 (19): 2186-2191.
8. KARNOFSKY DA. Clinical evaluation of anticancer drugs: cancer chemotherapy [J]. GANN Monogr 1967,2:223-231.
9. JANJAN NA. Radiation for bone metastases: conventional techniques and the role of systemic radiopharmaceuticals [J]. Cancer, 1997,80:1628-1645.
10. YOUNG RF, POST EM, KING GA. Treatment of spinal epidural metastases:randomized prospective comparison of laminectomy and radiotherapy [J]. J Neurosurg, 1980, 53:741-748.
11. JANJAN NA. Radiation for bone metastases: conventional techniques and the role of systemic radiopharmaceuticals [J]. Cancer, 1997,80:1628-1645.
12. BYRNE TN. Spinal cord compression from epidural metastases [J]. N Engl J Med, 1992, 327: 614619.
13. LOBLAW DA, PERRY J, CHAMBERS A, LAPERRIERE NJ. Systematic review of the diagnosis and management of malignant extradural spinal cord compression [J].J Clin Oncol,2005, 23: 2028-2037.
14. DOPPMAN JL, GIRTON RT. Angiographic study of the effect of laminectomy in the presence of acute anterior epidural masses [J].J Neurosurg, 1976,45:195-202.
15. KANAYAMA M, NG JT, CUNNINGHAM BW, et al. Biomechanical analysis of anterior versus circumferential spinal reconstruction for various anatomic stages of tumor lesions [J].Spine,1999,24: 445-450.
16. SANMILLAN RUIZD, BURKHARDT K, JEAN B, et al. Pathology findings with acrylic imp lants [J].Bone, 1999, 25 (2 Supp l): 85-90.

West China Medical Journal

Anterior Approaches with Vertebrectomy followed by Spinal Stabilization for Patients with Metastatic Thoracic Disease

Abstract Full text Figures/Tables Video References Cited by

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