Botelho Ricardo Vieira, de Oliveira Matheus Fernandes, Rotta Jose Marcus
Department of Neurosurgery, Hospital do Servidor Público Estadual de São Paulo, IAMSPE, São Paulo, Brazil.
Open Orthop J. 2013 Aug 19;7:286-91. doi: 10.2174/1874325001307010286. eCollection 2013.
For patients with a solitary and well-delimitated spinal metastasis that resides inside the vertebral body, without vertebral canal invasion, and who are in good general health with a long life expectancy, en bloc spondylectomy/total vertebrectomy combined with the use of primary stabilizing instrumentation has been advocated. However, clinical experience suggests that these qualifying conditions occur very rarely.
The purpose of this paper is to quantify the distribution of vertebral involvement in spinal metastases and determine the frequency with which patients can be considered candidates for radical surgery (en bloc spondylectomy).
Consecutive patients were classified accordingly to Enneking's and Tomita's schemes for grading vertebral involvement of metastases.
Fifty-one (51) consecutive patients were evaluated. Eighty-three percent of patients presented with the involvement of multiple vertebral levels and/or spinal canal invasion.
Because of diffuse vertebral involvement of metastases, no patients in this sample were considered to be candidates for radical spondylectomy of vertebral metastasis.
对于椎体内部存在孤立且边界清晰的脊柱转移瘤、无椎管侵犯、全身状况良好且预期寿命较长的患者，提倡采用整块脊椎切除术/全椎体切除术并结合使用一期稳定器械。然而，临床经验表明，这些符合条件的情况非常罕见。
本文旨在量化脊柱转移瘤中椎体受累的分布情况，并确定可被视为根治性手术（整块脊椎切除术）候选者的患者频率。
根据Enneking和Tomita的方案对连续患者的转移瘤椎体受累情况进行分级。
对51例连续患者进行了评估。83%的患者存在多个椎体节段受累和/或椎管侵犯。
由于转移瘤椎体受累广泛，该样本中无患者被视为椎体转移瘤根治性脊椎切除术的候选者。
