摘要
脊柱是恶性肿瘤患者常见转移部位,肿瘤转移至脊柱后可导致疼痛、病理性骨折和神经压迫。为了优化脊柱转移瘤以及转移性脊髓压迫(metastatic spinal cord compression,MSCC)患者诊断和管理方法,2008年英国国家卫生与临床优化研究所(NICE)提出了首个英国关于MSCC患者(或存在MSCC风险)的诊疗指南。近年来,随着脊柱外科与放疗技术的飞速进步,MSCC的标准化诊疗流程也需要更新。2023年,NICE推出了脊柱转移瘤和MSCC新版指南。本文在对该指南进行充分研读基础上进行论述和解读,内容涵盖疼痛管理、皮质类固醇治疗、双磷酸盐和地诺单抗应用、评估脊柱稳定性和预后的工具选择、放疗、手术时机和手术方式等,供国内临床诊疗参考。
Spine is a common site of metastasis in patients with malignant tumors,and tumor metastasis to the spine can lead to pain,pathological fractures,and nerve compression.In order to optimize the diagnosis and management of patients with spinal metastases and metastatic spinal cord compression(MSCC),the National Institute for Health and Care Excellence(NICE)in the UK proposed the first diagnostic and treatment guidelines for patients with MSCC(or at risk of MSCC)in 2008.In recent years,with the rapid advancement of spinal surgery and radiotherapy technology,the standardized process of MSCC diagnosis and treatment urgently needs to be updated.In 2023,NICE launched new guidelines for spinal metastases and MSCC.Based on a thorough study of the guidelines,this article discusses and interprets pain management,corticosteroid treatment,application of bisphosphonates and denosumab,tools for assessing spinal stability and prognosis,radiation therapy,surgical timing and approach,etc.,providing reference for clinical diagnosis and treatment in China.
作者
李杰
陈雷
胡伦灯
林建华
LI Jie;CHEN Lei;HU Lundeng;LIN Jianhua(Department of Orthopedics,the First Affiliated Hospital,Fujian Medical University,Fuzhou Fujian,350005,P.R.China;Department of Orthopedics,National Regional Medical Center,Binhai Campus of the First Affiliated Hospital,Fujian Medical University,Fuzhou Fujian,350212,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2024年第9期1035-1039,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
脊柱转移瘤
转移性脊髓压迫
指南
Spinal metastases
metastatic spinal cord compression
guidelines
