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目的 报道手术治疗脊柱转移瘤39例。方法 我院自1982年6月至1998年9月共行手术治疗脊柱转移瘤39例,脊柱是骨转移瘤的好发部位。最常见的原发病是肺癌、肝癌。手术主要分为前路椎体切除同时恢复脊柱稳定性和后路全椎板切除减压术两大类。结果 39例病人有37例疼痛消失或缓解(94.9％),脊髓压迫症15例中有13例治愈或缓解(86.7％),马尾神经综合症6例中有5例治愈或缓解(83.3％)。全部获随访,1年内死亡16例,1年～2年死亡10例,2年～3年死亡6例,3年～4年死亡3例。4年～5年死亡2例,至今存活2例,其中1例存活5年半,1例存活6年。结论 脊柱转移瘤手术治疗的目的是缓解疼痛、解除脊髓神经压迫、恢复脊柱稳定性,改善生存质量及在可能情况下延长生命,而脊柱转移瘤患者的存活期主要与原发病有关而与手术本身无关。
Objective To report the surgical treatment of spinal metastases in 39 cases. Methods In our hospital from June 1982 to September 1998, a total of 39 cases of spinal metastases were treated surgically. The spine was a predilection site for bone metastases. The most common primary disease is lung cancer, liver cancer. Surgery is mainly divided into anterior vertebroplasty while restoring spinal stability and posterior total laminotomy decompression of two categories. Results The pain disappeared or relieved in 37 patients (94.9%) in 39 patients. Thirteen patients (86.7%) were cured or relieved in 15 patients (86.3%) with spinal cord compression syndrome and 5 (53.3%) were cured or relieved in 6 patients with cauda equina syndrome . All were followed up, 16 cases died in 1 year, 10 cases died in 1 year to 2 years, 6 cases died in 2 years to 3 years and 3 cases died in 4 years. Two patients died within 4 years to 5 years and 2 patients survived. One patient survived for 5 years and a half and one patient survived for 6 years. Conclusion The purpose of surgical treatment of spinal metastases is to relieve pain, relieve spinal cord compression, restore spinal stability, improve quality of life and prolong life if possible. However, the survival of patients with spinal metastases is mainly related to the primary disease and surgery It has nothing to do with itself.