论文部分内容阅读
背景:胸腰椎肿瘤破坏椎体导致脊柱不稳及脊髓损害,肿瘤切除同时重建脊柱的稳定和患者神经功能的恢复一直为脊柱外科关注的热点。目的:探讨钛网联合前路内固定系统对重建胸腰椎肿瘤患者脊柱稳定性及神经功能恢复的作用。设计:前后对照研究。单位:广州军区广州总医院骨科。对象:2002-04/2003-11广州军区广州总医院收治的原发胸腰椎肿瘤患者、胸腰椎转移性肿瘤患者。方法:总结12例胸腰椎肿瘤切除,植骨、钛网联合前路内固定系统的方法。随访2～19个月(平均8个月)。主要观察指标:神经功能的恢复按Frankel分级进行观察,定期X射线观察骨融合及内固定情况。结果:术后症状均有缓解,神经功能恢复优良,术后2～4周Frankel分级D级7例、E级5例。未发现内固定松动、移位现象,良好率达100%。结论:钛网联合前路内固定系统应用于胸腰椎肿瘤切除后脊柱稳定重建和神经功能恢复,效果满意。
BACKGROUND: Thoracolumbar spine tumors destroy the vertebral body and lead to spinal instability and spinal cord injury. The tumor resection and reconstruction of the spine are stable and the recovery of neurological function of patients has been the focus of spine surgery. Objective: To investigate the effect of titanium mesh combined with anterior fixation system on spinal stability and neurological function in patients with thoracolumbar spine reconstruction. Design: A contextual control study. Unit: Guangzhou General Hospital of Guangzhou Military Region orthopedic. Subjects: Patients with primary thoracolumbar tumors and thoracolumbar metastases who were admitted to Guangzhou General Hospital of Guangzhou Military Command from April 2002 to November 2003. Methods: 12 cases of thoracolumbar tumor resection, bone graft and titanium mesh combined with anterior fixation system were summarized. Follow up for 2 ~ 19 months (average 8 months). MAIN OUTCOME MEASURES: The recovery of nerve function was observed by Frankel classification, and regular X-ray was used to observe the bone fusion and internal fixation. Results: The postoperative symptoms were relieved and the neurological function recovered well. Frankel grade D was 7 cases and grade E 5 cases 2 ~ 4 weeks after operation. No internal fixation was found loosening, displacement phenomenon, a good rate of 100%. Conclusion: The titanium mesh combined with anterior fixation system is effective in the stable reconstruction of spine and neurological function after thoracolumbar tumor resection.