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脊柱转移性乳腺癌手术治疗的后路入路评估

ASSESSMENT OF THE POSTERIOR APPROACH FOR SURGICAL TREATMENT OF SPINAL METASTATIC BREAST CANCER.

作者信息

Pontes Mariana Demétrio de Sousa, Pires Breno de Paula Faleiros, Albuquerque Felipe de Paula, Herrero Carlos Fernando Pereira da Silva

机构信息

Universidade de São Paulo, Ribeirão Preto Medical School, Department of Biomechanics, Medicine and Rehabilitation of Locomotor, Ribeirão Preto, SP, Brazil.

Universidade de São Paulo, Ribeirão Preto Medical School, Ribeirão Preto, SP, Brazil.

出版信息

Acta Ortop Bras. 2020 Jan-Feb;28(1):22-25. doi: 10.1590/1413-785220202801223529.

Abstract

OBJECTIVE

To assess the clinical and radiological aspects of patients with spinal metastatic breast cancer who underwent surgical treatment by posterior approach.

METHODS

This is a retrospective and descriptive study. Clinical assessment included the patient's sex, age, surgical treatment employed and complications. Radiological assessment comprised the study of the morphopathological characteristics of the lesions.

RESULTS

Data from 44 patients (93.2% female) submitted to surgical treatment of spinal metastasis were collected. The average age of diagnosis was 56.79 years. Decompression and posterior fixation with pedicle screws were performed in 43.1% of patients, while 36.3% underwent decompression and posterior fixation with pedicle screws associated with corpectomy and replacement with intersomatic device filled with bone cement. In 20.4%, kyphoplasty was the chosen procedure. Eighteen percent of patients had surgical complications, and the thoracic spine was most affected by the tumor.

CONCLUSION

The clinical and radiological presentation of this group of patients is variable. The posterior portion of the vertebrae was more affected than the anterior. Although surgical treatment by posterior approach does not have the objective of curing the underlying disease, it can present favorable results, with higher rate of complication in major surgeries.

摘要

目的

评估采用后路手术治疗的脊柱转移性乳腺癌患者的临床和影像学特征。

方法

这是一项回顾性描述性研究。临床评估包括患者的性别、年龄、所采用的手术治疗方法及并发症。影像学评估包括对病变形态病理学特征的研究。

结果

收集了44例接受脊柱转移瘤手术治疗患者的数据(93.2%为女性)。诊断时的平均年龄为56.79岁。43.1%的患者进行了椎弓根螺钉减压及后路固定,36.3%的患者接受了椎弓根螺钉减压及后路固定并联合椎体次全切除及骨水泥填充椎间融合器置换术。20.4%的患者选择了椎体后凸成形术。18%的患者出现手术并发症,胸椎受肿瘤影响最为严重。

结论

该组患者的临床和影像学表现各异。椎体后部比前部受影响更严重。尽管后路手术治疗并非旨在治愈基础疾病,但仍可取得良好效果,且大手术的并发症发生率较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b46/7006534/4b49c134579b/1809-4406-aob-28-01-22-gf1.jpg

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