椎体成形联合减压内固定治疗合并神经症状的胸腰椎转移性肿瘤

发布时间：2018-03-10 14:03

本文选题：胸腰椎　切入点：转移性肿瘤　出处：《重庆医学》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨椎体成形联合椎管减压椎弓根钉棒系统内固定治疗合并神经症状的胸腰椎转移性肿瘤的近期临床疗效分析。方法 2013年6月至2015年11月收治合并神经症状的脊柱转移性肿瘤患者26例,男16例,女10例;年龄44~72岁,平均60.5岁;胸椎10例,腰椎16例。按Frankel神经功能分级法A级2例,B级4例,C级8例,D级12例。观察手术时间、出血量,术前、术后及随访期间摄X线片及CT。采用视觉疼痛(VAS)评分及Oswestry功能障碍指数(ODI)评分系统来评估术前、术后的临床疗效。结果所有患者均获随访,平均随访13.6个月,手术时间3~5h,平均3.88h,出血量平均938mL。随访期间无内固定器松动,病椎高度无降低。术后按Frankel神经功能分级,23例患者得到明显改善。术前与术后患者VAS评分及ODI评分系统来评估有明显改善。结论椎体成形联合椎管减压内固定术疗效确切,能明显缓解胸腰椎转移性肿瘤患者的疼痛,改善神经功能和提高生活质量。
[Abstract]:Objective to investigate the clinical effect of vertebroplasty combined with decompression pedicle screw and rod system in the treatment of thoracolumbar metastatic tumors with neurological symptoms. Methods from June 2013 to November 2015, we treated patients with neurosis. 26 patients with metastatic tumors of the spine, 16 males and 10 females, aged 4472 years (mean 60.5 years), thoracic vertebrae (10 cases) and lumbar vertebrae (16 cases). According to the Frankel neural function classification method, 2 cases of grade A, 4 cases of grade B, 8 cases of grade C, grade D, 12 cases. X ray films and CTS were taken after operation and follow up. The visual pain score and Oswestry dysfunction index were used to evaluate the clinical efficacy before operation. Results all the patients were followed up for an average of 13.6 months. The mean operation time was 3.88 hours, and the mean blood loss was 938 mL. There was no loosening of the internal fixator during the follow-up. There was no decrease in the height of the diseased vertebrae. According to the classification of Frankel neurological function, 23 patients were obviously improved. The VAS score and ODI scoring system were used to evaluate the patients before and after the operation. Conclusion Vertebroplasty combined with decompression and internal fixation of spinal canal is effective. It can relieve pain, improve nerve function and improve quality of life in patients with metastatic tumors of thoracolumbar vertebrae.
【作者单位】：四川省医学科学院/四川省人民医院骨科;成都416医院脊柱骨科;
【分类号】：R738

【参考文献】