Abi Lahoud G, Abi Jaoude S
Unité de chirurgie de la colonne vertébrale et de la moelle épinière, service de neurochirurgie, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France.
Unité de chirurgie de la colonne vertébrale et de la moelle épinière, service de neurochirurgie, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75014 Paris, France.
Cancer Radiother. 2016 Oct;20(6-7):484-92. doi: 10.1016/j.canrad.2016.07.086. Epub 2016 Sep 7.
The spine is the most common site of skeletal metastases. Treatment decisions for patients with spinal metastases can be challenging and greatly depend on survival prognosis. Surgery remains a valuable weapon in the therapeutic arsenal. A review of the literature describing the role of surgery, the various surgical approaches and the prognostic scores available for the management of spinal metastases was performed and summarized. Surgery for spinal metastases has 3 main objectives: management of pain, achievement of mechanical stability and preservation or restoration of neurological function. A variety of surgical approaches are available and depend on location of tumor, presence of instability, neurological status, oncologic prognosis, general performance status and subsequent treatment measures. The goal of any therapeutic course for a spinal metastasis is the best oncologic and functional result with the least aggressive treatment. Novelty surgical and adjunctive measures allow a multidisciplinary approach to the metastatic spine.
脊柱是骨转移最常见的部位。脊柱转移瘤患者的治疗决策具有挑战性，很大程度上取决于生存预后。手术仍然是治疗手段中的重要武器。我们对描述手术作用、各种手术方法以及可用于脊柱转移瘤治疗的预后评分的文献进行了回顾并总结。脊柱转移瘤手术有3个主要目标：控制疼痛、实现机械稳定性以及保留或恢复神经功能。有多种手术方法可供选择，这取决于肿瘤的位置、是否存在不稳定、神经状态、肿瘤预后、一般身体状况以及后续治疗措施。脊柱转移瘤任何治疗过程的目标都是以最保守的治疗获得最佳的肿瘤学和功能结果。新颖的手术和辅助措施使得对转移性脊柱的治疗能够采用多学科方法。
