Sundaresan Narayan, Rosen Gerald, Boriani Stefano
Mount Sinai Medical School, 1148 Fifth Avenue, New York, NY 10128, USA.
Orthop Clin North Am. 2009 Jan;40(1):21-36, v. doi: 10.1016/j.ocl.2008.10.004.
Primary malignant tumors of the spine account for less than 5% of primary bone tumors. Data from the SEER program suggest that the most common bone sarcomas are osteosarcoma, chondrosarcoma, Ewing's sarcoma, chordoma, and malignant fibrous histiocytoma/fibrosarcoma. During the last two decades, tremendous progress has been made in clinical aspects, surgical approaches, and reconstruction with instrumentation at all levels of the spine. Stabilization procedures, including vertebroplasty and kyphoplasty, have further allowed palliation of pain and symptom relief from compression fractures. Improved radiation techniques have offered the potential for improved local control. This article reviews the changes in surgical philosophy in the management of malignant spinal tumors during the past two decades.
脊柱原发性恶性肿瘤占原发性骨肿瘤的比例不到5%。监测、流行病学与最终结果（SEER）项目的数据表明，最常见的骨肉瘤包括骨肉瘤、软骨肉瘤、尤因肉瘤、脊索瘤以及恶性纤维组织细胞瘤/纤维肉瘤。在过去二十年中，脊柱各个层面在临床、手术方法以及器械重建方面均取得了巨大进展。包括椎体成形术和后凸成形术在内的稳定手术，进一步实现了缓解疼痛以及减轻压缩性骨折症状的目的。改进后的放射技术提高了局部控制的可能性。本文回顾了过去二十年中恶性脊柱肿瘤治疗的手术理念变化。
