后路一期全脊椎切除及脊柱重建术治疗脊柱转移癌效果

发布时间：2018-01-22 13:39

本文关键词： 脊柱胸腰段转移性肿瘤全脊椎切除术临床疗效分析　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨后路一期全脊椎切除及脊柱稳定性重建术对胸腰椎单脊椎脊柱转移癌的术后疗效。方法:回顾分析2013年1月至2015年6月我院手术治疗的脊柱转移癌患者15例,全部患者均行后路病变椎体切除、受压脊髓360°环形减压,人工椎体VBOSS椎体支持系统植骨融合、后路椎弓根螺钉系统重建脊柱的稳定性,比较手术前后疼痛程度及神经功能状态的改善、病变椎体局部复发情况、内固定系统稳定情况及患者的预后。结果:15例患者均获得随访资料(3~18个月),术后疼痛程度明显改善,视觉模拟评分(VAS)从术前(5.07±1.33)分下降到术后(2.13±1.30)分(P0.05)。14例术前有神经功能障碍者10例大部分恢复,4例部分恢复,Frankel分级从术前的(3.60±0.83)上升到术后的(4.43±0.46)(P0.05)。随访过程中1例乳腺癌患者和1例肺癌患者死亡,余患者病椎切除局部未见复发,椎弓根螺钉及人工椎体支持系统无松动,植骨融合良好,预期生存期延长。结论:对于转移癌累及脊柱胸腰椎单节段的患者,后路一期全脊椎病变切除及脊柱稳定性重建术能减轻患者的疼痛程度及神经功能恢复,明显改善生活质量,延长预期生存期。
[Abstract]:Objective: to investigate the effect of posterior stage total spinal resection and spinal stability reconstruction in the treatment of thoracolumbar spinal metastases. From January 2013 to June 2015, 15 patients with spinal metastases were retrospectively analyzed. All the patients underwent posterior vertebral resection, decompression of the compressed spinal cord at 360 掳, bone graft fusion of the VBOSS vertebra support system, and posterior pedicle screw system to reconstruct the stability of the spine. The degree of pain and the improvement of neurological function before and after operation were compared, and the local recurrence of the lesion was compared. Results all 15 patients were followed up for 3 ~ 18 months, and the pain degree was improved significantly after operation. Visual analogue score (VAS) decreased from 5.07 卤1.33 before operation to 2.13 卤1.30 after operation (P0.05). 14 cases had neurological dysfunction before operation in 10 cases, most of them recovered. 4 cases partially recovered. The Frankel grade increased from 3.60 卤0.83 before operation to 4.43 卤0.46 after operation (P0.05). 1 case of breast cancer and 1 case of lung cancer died during follow-up. No recurrence was found in other patients, no loosening of pedicle screw and artificial vertebrae support system, good bone graft fusion, and long life expectancy. Conclusion: for patients with metastatic carcinoma involving one segment of thoracolumbar spine and lumbar vertebrae, there is no loosening of pedicle screw and artificial vertebral body support system. Posterior stage total spondylopathy resection and spinal stability reconstruction can reduce the pain and recovery of nerve function, improve the quality of life and prolong the expected life span.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R738

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