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目的:评价U形钛板在前路腰骶段肿瘤切除脊柱稳定性重建手术中的应用效果。方法:21例腰骶椎肿瘤患者均采取前方手术入路,肿瘤切除后6例良性肿瘤患者应用自体髂骨植骨、钛板内固定,15例恶性肿瘤患者采用骨水泥填充、钛板内固定。随访观察治疗效果。结果:所有患者随访8～24个月,平均16个月,腰骶部疼痛及骶神经压迫症状均明显改善,6例良性肿瘤患者3个月后均达骨性融合;15例应用骨水泥填充治疗的恶性肿瘤患者内置物位置良好无移位,1例患者术后16个月死于肺转移,1例术后未坚持放化疗,3个月后局部复发,出现瘫痪症状,余13例未见肿瘤局部复发和转移。所有患者内固定无松动和断裂。结论:前路腰骶段脊柱肿瘤切除后应用骨水泥或自体髂骨植骨加前路钛板内固定有利于维持脊柱及骨盆的连续性,可前路一期完成减压和稳定性重建,固定牢靠,创伤较小,是腰骶段脊柱稳定性重建可选择的方式之一。
Objective: To evaluate the effect of U-shaped titanium plate in reconstructive spinal surgery of anterior lumbosacral tumors. Methods: Twenty-one patients with lumbosacral vertebral tumors were treated by anterior approach. Six patients with benign tumors after resection of the tumors were treated with autologous iliac bone graft and titanium plate fixation. Fifteen patients with malignant tumors were treated with bone cement and titanium plate . Follow-up observation of the therapeutic effect. Results: All patients were followed up for 8-24 months, with an average of 16 months. The symptoms of lumbosacral pain and sacral nerve compression were significantly improved. All 6 patients had benign tumor fusion after 3 months. Fifteen patients were treated with bone cement Malignant tumor patients treated with good placement of internal objects without displacement, 1 patient died of lung metastasis 16 months after operation, 1 patient did not adhere to radiotherapy and chemotherapy, 3 months after the local recurrence of paralysis, the remaining 13 cases were not See the tumor local recurrence and metastasis. All patients with internal fixation without loosening and rupture. Conclusion: Anterior lumbosacral spine tumor resection using bone cement or autologous iliac bone graft plus anterior plate fixation is conducive to maintaining the continuity of the spine and pelvis, can be the first phase to complete the decompression and stability reconstruction, Fixed solid, less trauma, lumbosacral spine stability reconstruction is one of the options.