Zhao Yong-Jie, Cao Hai-Yan, Zhu Xiao-Dan, Deng Ming-Ming, Deng Xiao-Qiang, Sun Shui, Hu Yong-Cheng, Zhao Ming
The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China.
Binzhou Medical University Hospital, Binzhou, China.
Sci Rep. 2025 Aug 24;15(1):31142. doi: 10.1038/s41598-025-17125-8.
Between 2000 and 2019, data of hospitalizations with lower lumbar spinal metastasis were extracted from six medical centers in China. A total of 505 patients were identified in this study. Peak patients occurred in the group aged from 60 to 69 years, the age at diagnosis of female patients was 2.62 years earlier than that of male patients, and the proportion of male patients aged over 60 years was higher than that of females. Three most prevalent primary tumor were lung cancer, unknown origin tumor, and breast cancer. Solitary L4 metastases were nearly same as solitary L5 metastases. In terms of intervention, 347 patients (68.71%) received systemic treatment, while 158 patients (31.29%) underwent surgical therapy comprised of minimally invasive surgery (28 cases, 17.72%) and open surgery (130 cases, 82.28%). According to multivariate logistic analysis, SINS score, medical center, CCI, and segment of involved vertebrae were four independent predictors of surgical decision-making. This study represents the largest series of patients with lower lumbar metastases in the literatures. Due to several unique anatomic and biomechanical considerations with respect to metastases to the lower lumbar region, some characteristics are not completely commensurate with other spinal segmental metastases, which reinforces the significance for translation to regular clinical practice.
2000年至2019年间，从中国六个医疗中心提取了下腰椎脊柱转移瘤的住院数据。本研究共纳入505例患者。患者高峰出现在60至69岁年龄组，女性患者的诊断年龄比男性患者早2.62岁，60岁以上男性患者的比例高于女性。最常见的三种原发肿瘤为肺癌、原发灶不明肿瘤和乳腺癌。孤立性L4转移与孤立性L5转移情况相近。在干预方面，347例患者（68.71%）接受了全身治疗，而158例患者（31.29%）接受了手术治疗，其中包括微创手术（28例，17.72%）和开放手术（130例，82.28%）。根据多因素logistic分析，SINS评分、医疗中心、CCI和受累椎体节段是手术决策的四个独立预测因素。本研究是文献中最大规模的下腰椎转移瘤患者系列研究。由于下腰椎区域转移瘤存在一些独特的解剖和生物力学因素，其某些特征与其他脊柱节段转移瘤并不完全相同，这凸显了将研究结果应用于常规临床实践的重要性。
