【摘要】：目的探討一期單純后路全脊椎整塊切除治療腰椎腫瘤的手術(shù)方法與臨床療效。方法回顧性分析自2008-10—2015-12行一期單純后路全脊椎整塊切除、前路鈦籠植骨重建、后路椎弓根釘棒系統(tǒng)內(nèi)固定術(shù)治療的12例腰椎腫瘤。結(jié)果本組手術(shù)時(shí)間200~410 min,平均300 min;術(shù)中失血量800~5 200 ml,平均1 200 ml。4例獲得廣泛邊界,5例為邊緣性邊界,3例為病灶內(nèi)切除。12例隨訪2~60個(gè)月,平均40.8個(gè)月。在隨訪期內(nèi)腫瘤無(wú)復(fù)發(fā),5例轉(zhuǎn)移瘤患者帶瘤生存。所有患者未出現(xiàn)內(nèi)固定失敗,X線片均顯示植骨融合。術(shù)后所有患者神經(jīng)功能獲得改善或保持原有水平,術(shù)后Frankel分級(jí):B級(jí)1例,C級(jí)3例,D級(jí)5例,E級(jí)3例。結(jié)論一期單純后路全脊椎整塊切除治療腰椎腫瘤可獲得滿意的局部控制和功能恢復(fù),創(chuàng)傷小、并發(fā)癥少,能提高患者的生活質(zhì)量。
[Abstract]:Objective to investigate the surgical method and clinical effect of single posterior total spinal mass resection in the treatment of lumbar spine tumor. Methods A retrospective analysis of 12 cases of lumbar vertebrae tumors was performed from 2008-10-2015-12 with single posterior total spinal mass resection, anterior titanium cage bone graft reconstruction and posterior pedicle screw system internal fixation. Results the average intraoperative blood loss was 800 ~ (5 200) ml, for 200 ~ 410 min, and the average was 1 200 ml.4. Five patients with extensive margin and 3 with marginal margin were followed up for 2 ~ 60 months (mean 40.8 months). During the follow-up period, 5 patients with metastatic tumor survived without recurrence. No internal fixation failure was found in all patients. X-ray films showed bone graft fusion. The neurological function of all the patients was improved or maintained at the same level after operation. Frankel grade B was 1 case, grade C 3 cases, grade D 5 cases, grade E 3 cases. Conclusion the treatment of lumbar vertebrae tumor with single posterior total spinal mass resection can obtain satisfactory local control and functional recovery, with less trauma and less complications, and can improve the quality of life of the patients.
【作者單位】： 綿陽(yáng)市骨科醫(yī)院脊柱科;
【分類號(hào)】：R738

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