【摘要】 目的探讨上胸椎脊柱肿瘤并椎管占位的治疗方法。方法对8例侵犯机体的上胸椎单节段肿瘤并有椎管占位的患者采用后路椎弓根内固定,后路椎管减压,病灶刮除,经椎弓根应用蛋壳技术,刮除椎体内的肿瘤并注射骨水泥成形,随访6～18个月。结果本组已进行8例患者,均安全度过围手术期,患者1个月后均可坐起进食。未出现骨水泥渗漏、术后症状加重、感染、断钉及内固定脱落等并发症。结论后路经椎弓根蛋壳技术,能较完整的切除椎体肿瘤,同时可行椎管减压,刮除侵犯椎管的肿瘤组织,加上骨水泥填入成形,可以通过热效应消灭残余的肿瘤细胞,又可增强脊柱的稳定性,再加上椎弓根固定系统,更进一步增加了脊柱的稳定性。减轻患者手术痛苦,缩短了卧床时间,延长了患者生命。更多还原

【Abstract】 Objective To investigate the therapeutic option for monosegmental upper thoracic spinal tumor complicated by intracanal occupying lesion.Methods 8 patients with upper thoracic spinal tumor were treated with the surgical procedure of transpedicular instrumentation,decompression of the spind cord,resection of the bulk tumor and injection of bone cement which was performed by vertebroplasty eggshell procedure.Follow - up time lasted from 6 to 18 months.Results No perioperative or postoperative complications,such as bone cement intraspinal canal leakage,worse and infection,were observed in this invesgitation after operation.On average,oral intake started in a month.Furthmore,the long - term complications such as breakage of the nails or fall of the internal fixation.Conclusion Eggshell procedure of posterior transpedicular instrumentation can be performed to completely resect the tumor which conclude vertebral body and intraspinal canal,get the spind cord decompress.The bone cement for vertebroplasty could also kill the escaped tumor cell by thermal effect,enhance vertebral strength and stability combined with transpedicular instrumentation.This approach can relieve operation pains,decrease the bed - time and prolong life.更多还原