Abdelbaky Abdelaal, Eltahawy Hazem
Department of Neurosurgery Surgery, Benha University, Banha, Egypt.
Department of Neurosurgery Surgery, Wayne State University, MI, USA.
Asian J Neurosurg. 2018 Apr-Jun;13(2):247-249. doi: 10.4103/ajns.AJNS_43_16.
Spinal metastases lead to bony instability and spinal cord compression resulting in intractable pain and neurological deficits which affect ambulatory function and quality of life. The most appropriate treatment for spinal metastasis is still debated.
The aim of this study is to evaluate clinical outcome, quality of life, complications, and survival after surgical treatment of spinal metastases.
Retrospective review of patients with spinal metastases surgically treated at our facility between March 2008 and March 2013 was performed. Evaluations include hospital charts, initial and interval imaging studies, neurological outcome, and surgical complications. Follow-up examinations were performed every 3 months after surgery.
Seventy patients underwent surgical intervention for treatment of spinal metastasis in our institution. There were 27 women and 43 men. The preoperative pain was reported in 65 patients (93%), whereas postoperative complete pain relief was reported in 16 patients (24%), and pain levels decreased in 38 patients (58%). Preoperative 39 patients were ambulant and 31 patients were nonambulant. Postoperative 52 patients were ambulant and 18 patients were nonambulant. Postoperative complications were experienced in 10 (14.2%) patients, and the patient survival rate was 71% (50 patients) at 3 months, 49% (34 patients) at 1 year. The postoperative 30-day mortality rate was 4.2%.
Surgical decompression for a metastatic spinal tumor can improve the quality of life in a substantially high percentage of patients with acceptable complications rate.
脊柱转移瘤会导致骨质不稳定和脊髓受压，从而引发难以忍受的疼痛和神经功能缺损，影响行走功能和生活质量。脊柱转移瘤的最佳治疗方法仍存在争议。
本研究旨在评估脊柱转移瘤手术治疗后的临床疗效、生活质量、并发症及生存率。
对2008年3月至2013年3月期间在我院接受手术治疗的脊柱转移瘤患者进行回顾性研究。评估内容包括病历、初始及随访影像学检查、神经功能结果及手术并发症。术后每3个月进行一次随访检查。
我院70例患者接受了脊柱转移瘤手术治疗。其中女性27例，男性43例。65例患者（93%）术前有疼痛症状，术后16例患者（24%）疼痛完全缓解，38例患者（58%）疼痛程度减轻。术前39例患者可行走，31例患者不能行走。术后52例患者可行走，18例患者不能行走。10例患者（14.2%）出现术后并发症，3个月时患者生存率为71%（50例），1年时为49%（34例）。术后30天死亡率为4.2%。
转移性脊柱肿瘤的手术减压可使相当比例患者的生活质量得到改善，且并发症发生率可接受。
