Shoskes D A, Perrin R G
Department of Surgery, University of Toronto, Wellesley Hospital, Ontario, Canada.
J Urol. 1989 Aug;142(2 Pt 1):337-9. doi: 10.1016/s0022-5347(17)38750-5.
Spinal cord compression is a devastating complication of metastatic prostate cancer. We reviewed the experience at our center with 28 patients who underwent laminectomy for spinal cord compression secondary to adenocarcinoma of the prostate between January 1980 and November 1985. Patient age ranged from 46 to 82 years (mean age 65.5 years). The most common presenting complaints were back pain (75 per cent), loss of sensation (68 per cent) and loss of bladder function (39 per cent in retention). Postoperatively, 22 patients (79 per cent) had improvement of the presenting complaints. Of the 13 bedridden patients at presentation 8 (62 per cent) were ambulatory postoperatively. Of the 11 patients in retention 6 (55 per cent) were able to void postoperatively. There was no perioperative mortality. Four patients required further surgery, 2 had postoperative pneumonia and there were 2 wound infections. The average postoperative life span for the 17 patients not surviving to last followup was 9.5 months (range 1 to 60 months). The management of prostate cancer patients who have back pain and/or neurological findings is discussed. We believe that the rate of palliation and improved quality of life that decompressive laminectomy can afford patients with spinal cord compression due to prostate cancer justify its use in patients medically fit for the procedure.
脊髓压迫是转移性前列腺癌的一种严重并发症。我们回顾了1980年1月至1985年11月期间在我们中心28例因前列腺腺癌继发脊髓压迫而接受椎板切除术患者的经验。患者年龄在46岁至82岁之间（平均年龄65.5岁）。最常见的主诉是背痛（75%）、感觉丧失（68%）和膀胱功能丧失（39%为尿潴留）。术后，22例患者（79%）的主诉症状有所改善。就诊时13例卧床患者中，8例（62%）术后能够行走。11例尿潴留患者中，6例（55%）术后能够排尿。围手术期无死亡病例。4例患者需要进一步手术，2例发生术后肺炎，2例发生伤口感染。17例未存活至最后随访的患者术后平均生存期为9.5个月（范围1至60个月）。本文讨论了有背痛和/或神经学表现的前列腺癌患者的治疗。我们认为，减压性椎板切除术可为因前列腺癌导致脊髓压迫的患者带来的缓解率和生活质量改善，证明了该手术在身体状况适合手术的患者中使用的合理性。
