Haniuda M, Yamannda T, Aoki T, Kaneko K, Miyazawa M
Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Apr;43(4):506-10.
This article reports the author's experience with the surgical treatment of metastatic lung cancer to the thoracic spine. A 65-year-old woman (case 1) had undergone a right upper lobectomy with a diagnosis of adenocarcinoma. Three years later, she complained of severe back pain, and visited our hospital. CT scan showed a metastatic spine disease (Th6 and 7) which caused the back pain. A 59-year-old woman (case 27 was admitted to our hospital complaining of an abrupt onset of paraplegia. Two years ago, she underwent left upper lobectomy with a diagnosis of adenocarcinoma. Urgent examination revealed a large metastatic lesion on Th5 and 6 which compressed the spinal cord. After excision of the tumor as extensively as possible, the both patients underwent surgical decompression of the spinal cord, bone grafting and posterior reconstruction of the spine with a metallic instrumentation. Severe back pain was relieved postoperatively. Improvement of neurological deficit was dramatic in case 2. The goal of surgical treatment of metastatic thoracic spine disease is to improve the quality of the remaining life, by relief of pain and preservation or restoration of neurologic function. The dismal consequences of prolonged bed rest, paraplegia, and a painful premature death can be avoided with thoughtful and timely surgical treatment.
本文报道了作者对胸椎转移性肺癌的外科治疗经验。一名65岁女性（病例1）因腺癌诊断接受了右上叶切除术。三年后，她主诉严重背痛，前来我院就诊。CT扫描显示转移性脊柱疾病（胸6和胸7）导致背痛。一名59岁女性（病例2）因突然发生截瘫入住我院。两年前，她因腺癌诊断接受了左上叶切除术。紧急检查发现胸5和胸6有一个大的转移病灶压迫脊髓。在尽可能广泛切除肿瘤后，两名患者均接受了脊髓减压、植骨和脊柱后路金属器械重建手术。术后严重背痛得到缓解。病例2的神经功能缺损有显著改善。胸椎转移性疾病外科治疗的目标是通过缓解疼痛以及保留或恢复神经功能来提高剩余生命的质量。通过周到及时的外科治疗，可以避免长期卧床、截瘫和痛苦的过早死亡等悲惨后果。
