Larsen B H, Rohde K, Børgesen S E, Sørensen P S, Agerlin N, Bach F, Bøge-Rasmussen T, Gjerris F, Rasmusson B U, Stjernholm P M
Rigshospitalet, København, neuromedicinsk, neurokirurgisk og onkologisk, afdeling.
Ugeskr Laeger. 1990 Dec 3;152(49):3691-5.
A retrospective study of 398 patients suffering from metastatic compression of the spinal cord or cauda equina is presented. The study comprised almost all relevant medical records of patients admitted to hospital in the eastern part of Denmark in the period 1979 through 1985. Carcinoma of the lung, prostate, breast and kidney were the most frequent primary malignancies causing spinal compression. Most patients were treated with laminectomy, or radiotherapy or with laminectomy and radiotherapy combined. The effect of the treatment was estimated by evaluation of motor function and sphincter control. Treatment with laminectomy followed by radiotherapy was significantly superior to treatment with laminectomy or radiotherapy alone. But if the patients' motor function and primary tumour were taken into account, no significant difference between the treatments was observed. The efficacy of treatment depended upon the symptoms when the diagnosis was established, and accordingly early diagnosis is of the utmost importance. The incidence of metastatic compression increased during the period covered by the study, and since this condition must not go untreated, awareness of the symptoms, primarily pain, is essential.
本文呈现了一项对398例患有脊髓或马尾转移性压迫患者的回顾性研究。该研究涵盖了1979年至1985年期间丹麦东部地区住院患者几乎所有的相关病历。肺癌、前列腺癌、乳腺癌和肾癌是导致脊髓压迫最常见的原发性恶性肿瘤。大多数患者接受了椎板切除术、放射治疗或椎板切除术与放射治疗联合治疗。通过评估运动功能和括约肌控制来估计治疗效果。先进行椎板切除术然后进行放射治疗的效果明显优于单独进行椎板切除术或放射治疗。但是如果考虑患者的运动功能和原发性肿瘤,各治疗方法之间未观察到显著差异。治疗效果取决于确诊时的症状,因此早期诊断至关重要。在研究涵盖的期间内,转移性压迫的发病率有所上升,由于这种情况不能不进行治疗,所以对症状(主要是疼痛)的认识至关重要。