Qian Jun, Tian Ye, Hu Jian-hua, Qiu Gui-xing
Department of Orthopedics, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2010 May 4;90(17):1200-3.
To explore the surgical treatment method and outcome for subaxial cervical spine metastatic tumor.
We retrospectively analyzed 7 cases of subaxial cervical spine metastatic tumor treated at our hospital between 2002 and 2007. There were 3 male and 4 female patients. The primary lesions included 1 lung cancer, 1 renal cancer, 1 liver cancer, 2 gastric cancers and 2 breast cancers. All cases were treated with anterior vertebrectomy, reconstruction of cervical spine stability with mesh cage and plate fixation. Preoperative and 3-month postoperative VAS scores of neck pain and neurological status of Frankel classification were analyzed statistically. Cervical spine stability was observed by radiography during follow-up.
The preoperative and postoperative VAS scores of neck pain were 7.4 +/- 0.8 and 1.8 +/- 1.2 respectively. There was obvious statistical difference between two scores (t = 15.11, P = 0.000). The post-operative neurological status of Frankel classification improved by one to two grades. The mean follow-up period was 18 months except for one patient dying from multiple organ failure at 9 months post-operation. Radiology showed satisfactory cervical spine stability during follow-up.
For treating subaxial cervical spine metastatic tumor, anterior vertebrectomy, reconstruction with mesh cage and plate fixation is an effective method to relieve clinical pains and improve neurological functions by complete spinal cord decompression and cervical stability reconstruction.
探讨下颈椎转移性肿瘤的手术治疗方法及疗效。
回顾性分析2002年至2007年我院收治的7例下颈椎转移性肿瘤患者。其中男性3例，女性4例。原发肿瘤包括肺癌1例、肾癌1例、肝癌1例、胃癌2例、乳腺癌2例。所有病例均行前路椎体切除，采用椎间融合器及钢板内固定重建颈椎稳定性。对术前及术后3个月的颈部疼痛视觉模拟评分（VAS）以及Frankel分级的神经功能状态进行统计学分析。随访期间通过影像学观察颈椎稳定性。
术前及术后颈部疼痛VAS评分分别为7.4±0.8和1.8±1.2。两者评分差异有统计学意义（t = 15.11，P = 0.000）。术后Frankel分级神经功能状态改善1至2级。除1例患者术后9个月死于多器官功能衰竭外，平均随访时间为18个月。影像学显示随访期间颈椎稳定性良好。
对于下颈椎转移性肿瘤，前路椎体切除、椎间融合器及钢板内固定重建是通过完全脊髓减压和重建颈椎稳定性来缓解临床疼痛及改善神经功能的有效方法。
