Li Jie, Chen Lei, Hu Lundeng, Lin Jianhua
Department of Orthopedics, the First Affiliated Hospital, Fujian Medical University, Fuzhou Fujian, 350005, P. R. China.
Department of Orthopedics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou Fujian, 350212, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Sep 15;38(9):1035-1039. doi: 10.7507/1002-1892.202404108.
Spine is a common site of metastasis in patients with malignant tumors, and tumor metastasis to the spine can lead to pain, pathological fractures, and nerve compression. In order to optimize the diagnosis and management of patients with spinal metastases and metastatic spinal cord compression (MSCC), the National Institute for Health and Care Excellence (NICE) in the UK proposed the first diagnostic and treatment guidelines for patients with MSCC (or at risk of MSCC) in 2008. In recent years, with the rapid advancement of spinal surgery and radiotherapy technology, the standardized process of MSCC diagnosis and treatment urgently needs to be updated. In 2023, NICE launched new guidelines for spinal metastases and MSCC. Based on a thorough study of the guidelines, this article discusses and interprets pain management, corticosteroid treatment, application of bisphosphonates and denosumab, tools for assessing spinal stability and prognosis, radiation therapy, surgical timing and approach, ., providing reference for clinical diagnosis and treatment in China.
脊柱是恶性肿瘤患者常见的转移部位，肿瘤转移至脊柱可导致疼痛、病理性骨折和神经受压。为优化脊柱转移瘤和转移性脊髓压迫症（MSCC）患者的诊断与管理，英国国家卫生与临床优化研究所（NICE）于2008年提出了首个针对MSCC（或有MSCC风险）患者的诊断和治疗指南。近年来，随着脊柱外科手术和放疗技术的快速发展，MSCC诊断和治疗的标准化流程迫切需要更新。2023年，NICE发布了关于脊柱转移瘤和MSCC的新指南。本文在对该指南进行深入研究的基础上，对疼痛管理、皮质类固醇治疗、双膦酸盐和地诺单抗的应用、评估脊柱稳定性和预后的工具、放射治疗、手术时机和入路等进行了讨论和解读，为我国临床诊断和治疗提供参考。
