【摘要】 目的探讨脊柱肿瘤的合理手术方法。方法对收治的136例脊柱肿瘤病人,进行全身的检查,查找肿瘤的原发灶,并在CT监视下行病椎穿刺活检,确定肿瘤性质,制定治疗方案。结果行手术治疗的病例中,良性肿瘤病人9例,全部行病椎外科切除同期行脊柱重建,恶性肿瘤病例15例,全部行全脊椎切除。先期后路固定切除椎体附件,然后前路行病椎完全切除,取髂骨或钛网植骨前路内固定。所有手术病人术后随访1-5年,死亡3例,复发3例。18例全部存活,能够正常生活和工作。结论良性脊柱肿瘤,同期行病椎外科切除并重建脊柱稳定性,可以完全治愈;脊柱恶性肿瘤经过术前、术后化疗、放疗再行病椎全脊柱切除、重建脊柱稳定性,明显改善患者生活质量,提高5年生存率。更多还原

【Abstract】 Objective To explore the reasonable surgery method of patients with spinal tumor.Methods 136 patients with spinal tumor from 2000 to 2005 were generally examined to find the tumor’s primary focus before operation.The vertebra was punctured to detect the pathologic type of tumor with CT scan,and then confirm the treatment method.Results 8 cases were diagnosed as benign tumor,and then the vertebral tumor were removed and reconstructed the stability of the spine at the same time.15 cases were diagnosed as malignant tumor and then the vertebrae tumor was removed.In all 15 cases,the vertebral accessory was removed at first step and vertebra was fixed from the posterior approach.Secondly,the focus was removed from the anterior approach.The vertebra was fixed by using graft ilium or titanium cage.All these surgery patients were followed up from 1 to 5 years,3 cases died and 3 cases relapsed.Other 18 cases were survival.Conclusion Benign tumor can be cured.Malignant tumor can be treated by chemotherapeutics and actinotheraphy before or/and after operation beside the surgery,which can improve the patients living quality and increase 5 years living rates.更多还原