Zhang Gong-lin, Ge Bao-feng
Institute of Orthopaedics, Lanzhou General Hospital of PLA, Lanzhou 730050, Gansu, China.
Zhongguo Gu Shang. 2010 Jan;23(1):73-5.
The spine is the most common site of metastatic tumors. The highest incidence of metastatic tumors on the spine is in the lumbar region, followed by the thoracic and cervical levels. Most associated spinal cord lesions, however, are located in the thoracic spine. The goals of surgery is decompression of the neural tissues, prevention of neural injury by stabilization of the unstable spinal column,or pain control. When there is a need to decompress the neurologic tissues,the most direct approach is anterior because the most common site of metastatic tumors is in the vertebral body. Laminectomy alone is not effective in improving neurologic function. Nevertheless,the posterior approach is more accessible, less hazardous, and effective in the correction of deformity if combined with instrumentation. If complete vertebrectomy is feasible in anterior bone strut combined with anterior and posterior stabilization is necessary following the vertebrectomy.
脊柱是转移性肿瘤最常见的部位。脊柱转移性肿瘤的最高发病率位于腰椎区域,其次是胸椎和颈椎节段。然而,大多数相关的脊髓病变位于胸椎。手术的目标是减压神经组织、通过稳定不稳定的脊柱防止神经损伤或控制疼痛。当需要减压神经组织时,最直接的方法是前路手术,因为转移性肿瘤最常见的部位是椎体。单纯椎板切除术对改善神经功能无效。然而,后路手术更容易操作,风险更小,并且如果结合内固定在矫正畸形方面是有效的。如果可行的话,前路椎体全切术联合前路和后路内固定是椎体切除术后所必需的。