一期单纯后路全脊椎整块切除治疗腰椎肿瘤

发布时间：2018-09-18 07:22

【摘要】：目的探讨一期单纯后路全脊椎整块切除治疗腰椎肿瘤的手术方法与临床疗效。方法回顾性分析自2008-10—2015-12行一期单纯后路全脊椎整块切除、前路钛笼植骨重建、后路椎弓根钉棒系统内固定术治疗的12例腰椎肿瘤。结果本组手术时间200~410 min,平均300 min;术中失血量800~5 200 ml,平均1 200 ml。4例获得广泛边界,5例为边缘性边界,3例为病灶内切除。12例随访2~60个月,平均40.8个月。在随访期内肿瘤无复发,5例转移瘤患者带瘤生存。所有患者未出现内固定失败,X线片均显示植骨融合。术后所有患者神经功能获得改善或保持原有水平,术后Frankel分级:B级1例,C级3例,D级5例,E级3例。结论一期单纯后路全脊椎整块切除治疗腰椎肿瘤可获得满意的局部控制和功能恢复,创伤小、并发症少,能提高患者的生活质量。
[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.
【作者单位】：绵阳市骨科医院脊柱科;
【分类号】：R738

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