摘要
[目的]探讨以脊柱病变为主的骨髓瘤的的诊断方法和外科治疗的指征、方式及效果。[方法]对本科自1996。2004年收治的13例以脊柱病变为主的骨髓瘤患者的临床表现、辅助检查及外科治疗情况进行回顾分析。本组资料13例患者，男性5例，女性8例，平均47．67岁。行X线、CT、MRI、ECT、术前／术中病理活检等检查，均行外科手术治疗：经前路椎体肿瘤切除、钛网植骨或骨水泥椎体植入、钢／钛板内固定7例，经后路全脊椎切除、钛网植骨、椎弓根钉固定4例，联合入路肿瘤切除、前路钛网植入、钛板内固定、后路经椎弓根固定2例。[结果]术后患者疼痛症状明显缓解，脊髓或神经根压迫症状改善，生活质量提高，2例截瘫患者Frankel分级分别由B级、C级变为D级，患者均获随访，平均随访36．75个月，1例复发，3例死亡。[结论]X线检查可提供诊断线索，CT与MRI在诊断和鉴别诊断中有重要作用，ECT检查可发现全身多个病灶，病理活检是可靠的诊断方法，选择性手术治疗可使患者症状得到明显持久缓解，须结合化疗、放疗等其他治疗，才能得到最好的治疗效果。
[ Objective] To discuss the diagnosis and surgical treatment of spinal myeloma, [ Method] To make a retrospective analysis of cliniacal history and operation results of 13 patients with spinal myeloma from 1999 to 2004. There were 5 males and 8 females with average age of 47.67 years. They were diagnosed by X-ray, CT, MRI, ECT and biopsy. Resection of tumor was performed in all cases, of which 7 cases was through anterior approach, 4 cases through posterior approach, 2 cases through combined approach. [ Result] The pain was decreased and neurological function was improved in all cases after the surgery. Three death and one recurrence was found during the follow-up time. [ Conclusion] X-ray, CT and MRI are essential for diagnosis, ECT may help found multiple lesions, biopsy is reliable diagnosable method. Surgery can relived the symptoms obviously, but should be associated with adjuvant treatments.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2006年第9期660-662,共3页
Orthopedic Journal of China
关键词
骨髓瘤
脊柱
诊断
手术
Myeloma
Spine
Diagnosis
Surgery
