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[通过拧入椎弓根的后路钢板固定进行脊柱转移瘤的外科治疗]

[Surgical treatment of spinal metastases by stabilization using posterior plates screwed into the vertebral pedicles].

作者信息

Roy-Camille R, Saillant G, Lapresle P, Mazel C, Mariambourg G

出版信息

Rev Chir Orthop Reparatrice Appar Mot. 1985;71(7):483-92.

PMID:4089263
Abstract

Ninety spinal metastases were treated by plating using a posterior approach. Fifty were thoracic or thoraco-lumbar, 11 in the upper cervical spine, 14 in the lower cervical spine and fifteen in the lumbar spine. Surgical fixation was followed by radiotherapy, chemotherapy or hormone therapy, when indicated. In the upper cervical region a special plate was screwed into the occiput. In the lower cervical spine fixation was accompanied by anterior vertebrectomy at the same procedure. In the entire series good stability was obtained in nine out of ten cases. Mortality during the first post-operative months was about 10 to 15 p. 100 dependent on the level. Two thirds of the patients gained some benefit from the operation. Cases with paraplegia and loss of independence had less favourable results than others. The ideal indications are threatened collapse of vertebrae, recent neurological impairment of severe pain resistant to conservative treatment.

摘要

采用后路钢板固定术治疗了90例脊柱转移瘤。其中50例为胸椎或胸腰段,11例在上颈椎,14例在下颈椎,15例在腰椎。如有指征,手术固定后进行放疗、化疗或激素治疗。在上颈椎区域,将一块特制钢板拧入枕骨。在下颈椎,固定时同时进行前路椎体切除术。在整个系列病例中,十分之九的病例获得了良好的稳定性。术后头几个月的死亡率约为10%至15%,取决于病变部位。三分之二的患者从手术中获得了一定益处。截瘫和失去自理能力的病例效果不如其他病例。理想的适应证是椎体有塌陷风险、近期出现神经功能损害或严重疼痛经保守治疗无效。

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