摘要
背景:下颈椎椎体转移癌会破坏颈椎的稳定性并导致颈髓的压迫,这类患者常需手术治疗。目的:观察前方入路病灶清除、钛网植骨重建及钛板置入内固定治疗下颈椎椎体转移癌的效果。方法:选择2005-06/2007-06广西医科大学第一附属医院脊柱骨病科收治的下颈椎椎体转移癌患者30例,均采用前方入路行病灶清除、钛网植骨重建及钛板置入内固定治疗。记录手术时间、下床活动时间、并发症、以Frankel评分衡量脊髓损伤情况,椎X射线片检查内固定物位置情况,部分患者行MRI检查局部复发及脊髓减压情况。结果与结论:手术时间90～150min,出血量100～600mL。手术过程中无并发症发生。所有患者均得到随访,随访时间12～24个月,平均14个月。随访中有3例患者因多处转移,全身衰竭死亡。末次随访中,9例患者由FrankelD级恢复到E级。随访中无断钉及内固定失效发生。提示经前方入路病灶清除、钛网植骨重建及钛板置入内固定是治疗下颈椎椎体转移癌的有效方法,具有病灶清除彻底、脊柱稳定性恢复好、患者术后可早期下地活动等优点。
BACKGROUND：Spinal metastatic disease may damage the spinal stability and cause the compression of the spinal cord. Therefore sugery treatment is always required. OBJECTIVE：To investigate an anterior approach for lower cervical metastasis tumor lesion. METHODS：A total of 30 patients with lower cervical metastatic tumor underwent anterior debridement,titanium mesh bone grafting and titanium plate internal fixation. Operation time,activity off bed,complication and Frankel scores were recorded. X-ray films were performed to detect implant position,Some patients additionally underwent MRI examination. RESULTS AND CONCLUSION：The operation time was 90-150 minutes,and the bleeding during operation was 100-600 mL. There was no postoperative complication. All patients were followed up for 12-24 months with an average time of 14 months,during which 3 patients were dead of systemic metastatic cancer. At the last follow-up visit,9 patients had Frankel Grade D improved to Grade E. There was no breakage of nails or failure of the internal fixation during the follow up. Tumor in lower cervical body treated with anterior debridement,titanium mesh bone grafting and titanium plate internal fixation achieved a high satisfactory rate in clearance of lesion and restoring spinal stability. Moreover,the patients can move early.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第39期7303-7306,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
