脊柱肿瘤切除术后稳定性重建的临床探究.docxVIP

脊柱肿瘤切除术后稳定性重建的临床探究 赣州市人民医院脊柱外科 江西赣州341000 第一作者简介：郭朝阳势(1970年生)主任医师研究方向：脊柱外科 [摘要]目的：探讨脊柱肿瘤切除术的稳定性重建方式及其效果。方法：筛选2012 年1月至2016年1月于我院接受手术治疗的脊柱原发性恶性肿瘤患者56例，作 为研究对象。行椎体切除22例，后弓切除14例，全脊椎切除12例，其它类型 8例，根据患者手术类型及切除范围选择性进行椎体重建、前方椎体内固定、后 路植骨内固定等术式，比较患者治疗前后的临床疗效及神经功能改善情况。结果: 所有患者于36个月内随访完成，其中有9例患者死亡，6例患者肿瘤复发再次 手术，除复发病例其余患者植骨全部融合H无植骨骨折现象，术中、术后无严重 神经功能损伤并发症。末次随访调查结果显示疼痛程度VAS评分明显低于术前, 神经功能ASIA分级明显优于术前，Plt;0.05,具有统计学意义。结论：脊柱肿 瘤切除手术根据切除范围以及具体疾病类型选择相应的稳定重建方式可有效恢 复患者脊柱的稳定性，改善患者疼痛程度及神经功能损伤情况，并对促进植骨融 合、提升手术治疗效果具有重要作用。 关键词：脊柱肿瘤切除术；稳定性重建；临床疗效；应用价值 【中图分类号】R856.2【文献标识码】A【文章编号】1001-5213(2016)08-0252-01 [abstract] objective: to study the stability of the spine tumor resection and effect of the rec on structi on. Methods: betwee n Janu ary 2012 an d Ja nu ary 2016in our hospital underwent surgical treatment of spinal primary 56 patients with malignant tumor, as the research object. 22 cases of vertebral resection was bow after 14 cases, and total spine resection in 12, 8 cases of other types, and the selective removal of range depending on the type of surgery in patients with vertebral body weight was built, in front of the vertebral body fixed, posterior bone graft fixation, such as surgery, compared before and after treatment in patients with the clinical curative effect and improve n erve function. Results: all patie nts completed 36 mon ths follow-up, including 9 cases of patients died, 6 patients with tumor recurrenee reoperation, except for cases of recurrenee of all the rest of the patients with bone graft fusion and without bone graft fracture phenomenon, intraoperative and postoperative neurologic injury without serious complication. The last follow-up survey pain VAS score sigrdficantly lower than the preoperative, neural function is better than preoperative staging ASIA, P lt; 0.05, with statistical sign讦icance. Conclusion: spinal tumor resection, and according to the scope of the removal of spec讦ic disease type choose corresponding stability reconstruction method can effective recov