Yokogushi K, Ishii S, Ono N, Owada O
Dept. of Orthopedic Surgery, Sapporo Medical College.
Gan To Kagaku Ryoho. 1988 Apr;15(4 Pt 2-3):1509-14.
We studied 38 patients with metastatic spinal tumors and discussed the indications and methods for surgical treatment. Metastatic spinal lesions were from carcinomas (31 cases) and sarcomas (7 cases). 20 patients underwent conventional decompressive laminectomy, 10 patients were treated by posterior decompressive laminectomy with stabilization, which included Harrington or Luque instrumentation. The remaining 8 patients were treated by anterior decompression and stabilization. Anterior decompression and stabilization (effective cases 87.5%) were better than the other procedures (effective cases of posterior decompressive laminectomy and stabilization: 70%: that of conventional laminectomy: 30%) to sustain relief of pain and reduction of paralysis. Our surgical procedures were palliative and directed at relief of pain and prevention of neurological deterioration. But our results suggested that the spinal column stabilization was worthwhile in treatment of metastatic spinal tumors.
我们研究了38例转移性脊柱肿瘤患者,并讨论了手术治疗的适应证和方法。转移性脊柱病变来自癌(31例)和肉瘤(7例)。20例患者接受了传统的减压性椎板切除术,10例患者接受了后路减压性椎板切除术并进行了内固定,其中包括哈林顿或鲁克器械固定。其余8例患者接受了前路减压和内固定。前路减压和内固定(有效率87.5%)在缓解疼痛和减轻瘫痪方面优于其他手术(后路减压性椎板切除术并内固定的有效率:70%;传统椎板切除术的有效率:30%)。我们的手术是姑息性的,旨在缓解疼痛和预防神经功能恶化。但我们的结果表明,脊柱内固定在转移性脊柱肿瘤的治疗中是值得的。