Fridley Jared S, Syed Sohail, Niu Tianyi, Leary Owen P, Gokaslan Ziya L
Department of Neurosurgery, Warren Alpert School of Medicine of Brown University, Providence, Rhode Island, USA.
Neurooncol Pract. 2020 Nov 18;7(Suppl 1):i18-i24. doi: 10.1093/nop/npaa051. eCollection 2020 Nov.
Metastatic spine disease occurs in more than 10% of all cancer patients. Advances in systemic treatment for cancer has led to improved overall survival for many types of cancer, which has increased the overall incidence of spinal metastases. The most common presenting complaint of patients with spinal metastases is pain. Pain originating from spinal metastases can be oncological, mechanical, and/or neurological in nature. Early recognition of these symptoms is helpful to guide treatment and accurately gauge patient prognosis. Unfortunately, the prevalence of degenerative back pain in the general population can complicate early clinical recognition of patients with metastatic spine disease. Therefore, back pain in any patient with a history of malignancy should prompt clinicians to perform an expedited workup for metastatic disease of the spine. Diagnostic imaging and laboratory studies are part of the initial work up. Obtaining pathology via biopsy to establish tumor histology is essential to determine the appropriate treatment.
超过10%的癌症患者会发生脊柱转移瘤。癌症全身治疗的进展使多种癌症患者的总生存期得到改善,这增加了脊柱转移瘤的总体发病率。脊柱转移瘤患者最常见的主诉是疼痛。源于脊柱转移瘤的疼痛本质上可能是肿瘤性、机械性和/或神经性的。早期识别这些症状有助于指导治疗并准确评估患者预后。不幸的是,普通人群中退行性背痛的患病率会使脊柱转移瘤患者的早期临床识别变得复杂。因此,任何有恶性肿瘤病史的患者出现背痛都应促使临床医生对脊柱转移性疾病进行快速检查。诊断性影像学检查和实验室检查是初始检查的一部分。通过活检获取病理以确定肿瘤组织学对于确定适当的治疗至关重要。