Fanous Andrew A, Fabiano Andrew J
Department of Neurosurgery, Roswell Park Cancer Institute, Buffalo, NY, USA.
Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
J Neurosurg Sci. 2017 Jun;61(3):316-324. doi: 10.23736/S0390-5616.16.03914-X. Epub 2016 Oct 27.
Spinal metastatic disease is a common occurrence in oncology. Spinal metastases may result in pain, spinal deformity, and neurologic deterioration. Surgical intervention is a key component in the effective management of spinal metastatic disease. The principles of neural decompression and spinal stabilization are hallmarks of the surgical care for patients with metastatic spinal disease. Several classification systems exist for spinal metastatic disease to aid in assessing preoperative spinal instability and the need for operative intervention. Treatment modalities include separation surgery, stereotactic radiosurgery, conventional radiotherapy, vertebral body augmentation, and laser-interstitial thermal therapy. Various open surgical approaches exist that may be employed to achieve operative goals during separation surgery. The spinal surgeon should be intimately involved in the overall care of patients with spinal metastatic disease to ensure the best clinical outcomes.
脊柱转移性疾病在肿瘤学中很常见。脊柱转移可能导致疼痛、脊柱畸形和神经功能恶化。手术干预是脊柱转移性疾病有效管理的关键组成部分。神经减压和脊柱稳定的原则是转移性脊柱疾病患者手术治疗的标志。脊柱转移性疾病有几种分类系统，以帮助评估术前脊柱不稳定情况和手术干预的必要性。治疗方式包括分离手术、立体定向放射外科、传统放疗、椎体强化和激光间质热疗。在分离手术期间，存在多种可用于实现手术目标的开放手术入路。脊柱外科医生应密切参与脊柱转移性疾病患者的全面护理，以确保最佳临床结果。
