Hammerberg K W
Department of Orthopedic Surgery, Rush Presbyterian St. Luke's Medical Center, Chicago, Illinois.
Spine (Phila Pa 1976). 1992 Oct;17(10):1148-53. doi: 10.1097/00007632-199210000-00004.
The results of surgical intervention for metastatic disease on 56 consecutive patients since 1980 were reviewed. Two patients underwent a second procedure to stabilize remote levels of spinal involvement, for a total of 58 surgeries. All 56 patients presented with pain. After surgery, significant relief was noted by 51 (91%). Twenty-seven patients presented with neurologic compromise. After operation, neurologic improvement was noted in 20 (74%). No patient's neurologic function deteriorated secondary to surgical intervention. Twenty-one patients were bedridden before surgery secondary to pain or paresis. After operation, improvement in activity level was achieved in 16 (76%) of these patients. In summary, the goal of surgical treatment of metastatic spine disease is to improve the quality of the remaining life, by the relief of pain and preservation or restoration of neurologic function. The dismal consequences of prolonged bed rest, paraplegia, and a painful premature demise can be avoided with thoughtful and timely surgical intervention.
回顾了自1980年以来连续56例转移性疾病患者的手术干预结果。2例患者接受了第二次手术以稳定远处脊柱受累节段，共进行了58次手术。所有56例患者均有疼痛症状。术后，51例（91%）患者疼痛明显缓解。27例患者存在神经功能损害。术后，20例（74%）患者神经功能得到改善。无患者因手术干预导致神经功能恶化。21例患者术前因疼痛或轻瘫而卧床。术后，其中16例（76%）患者活动水平得到改善。总之，转移性脊柱疾病的手术治疗目标是通过缓解疼痛以及保留或恢复神经功能来提高剩余生命的质量。通过深思熟虑和及时的手术干预，可以避免长期卧床、截瘫以及痛苦的过早死亡等悲惨后果。
