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转移性脊髓压迫症的诊断、治疗及其干预后护理的当前进展:一项综述

Current Advancements in the Diagnosis and Treatment of Metastatic Spinal Cord Compression and Its Postintervention Care: A Comprehensive Review.

作者信息

Kishore Avikalp, Piccioni Alessio, Fiallos Vinueza Ivana L, Younus Khan Ahmed Rasool, Kasab Moutasm, Lakshminarasimhan Deepika, Behbehani Duaa, Bushnaq Jahed, Ogunfunwa Olamide, Bittu Naga V

机构信息

Medicine, Gloucestershire NHS Foundation Trust, Gloucester, GBR.

Medicine and Surgery, Università di studi di Roma "La Sapienza", Rome, ITA.

出版信息

Cureus. 2025 Jun 15;17(6):e86049. doi: 10.7759/cureus.86049. eCollection 2025 Jun.

Abstract

Malignant spinal cord compression (MSCC) is a serious oncological emergency that can result in neurological impairment and significant pain. It is associated with high morbidity, mortality, and a decrease in quality of life. This review reviews the current literature concerning diagnosis, guidelines, timely intervention, and management options in oncology patients with MSCC. A literature search of PubMed using relevant keywords and MeSH terms yielded 604 articles. Of these, 31 studies met the predefined inclusion criteria and were selected for detailed data extraction and synthesis into a narrative review. MRI remains the gold standard for diagnosis, with newer systems like short tau inversion recovery (STIR) sequences being used, and includes the Bilsky grading system to improve classification and diagnosis for treatment. Radiotherapy and surgery continue to be the main treatment options. A multidisciplinary, personalized approach improves the amount of function recovered, pain control, and quality of life. New advances include robotic-assisted surgery and immunotherapy as future management options. Early recognition and clear, evidence-based guidelines are essential to reduce the morbidity and mortality of MSCC. This includes immediate administration of steroids, MRI imaging, and timely referral to appropriate departments, including acute oncology and neurosurgery. Additional research is needed to determine the main factors that impact patient recovery and quality of life.

摘要

恶性脊髓压迫(MSCC)是一种严重的肿瘤急症,可导致神经功能损害和剧烈疼痛。它与高发病率、死亡率以及生活质量下降相关。本综述回顾了有关MSCC肿瘤患者诊断、指南、及时干预和管理选择的当前文献。使用相关关键词和医学主题词(MeSH)在PubMed上进行文献检索,共获得604篇文章。其中,31项研究符合预先设定的纳入标准,被选出来进行详细的数据提取,并综合成一篇叙述性综述。磁共振成像(MRI)仍然是诊断的金标准,目前正在使用诸如短tau反转恢复(STIR)序列等更新的系统,并且包括Bilsky分级系统以改善治疗的分类和诊断。放射治疗和手术仍然是主要的治疗选择。多学科、个性化的方法可改善功能恢复程度、疼痛控制和生活质量。新进展包括机器人辅助手术和免疫治疗作为未来的管理选择。早期识别以及清晰、基于证据的指南对于降低MSCC的发病率和死亡率至关重要。这包括立即给予类固醇、进行MRI成像,并及时转诊至包括急性肿瘤学和神经外科在内的适当科室。需要进一步研究以确定影响患者恢复和生活质量的主要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b2d/12261808/c910eded4622/cureus-0017-00000086049-i01.jpg

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