摘要
目的 探讨侧方入路手术途径切除胸腰椎肿瘤和重建脊柱稳定性的临床疗效和意义。方法 2 9例T3 ～L4肿瘤患者 ,Frankel神经功能分级 :A级 3例 ,B级 5例 ,C级 7例 ,D级 6例 ,E级 8例。经侧方入路手术途径显露病椎前方、侧方和后方 ,切除肿瘤以及上下相邻椎间盘 ,然后根据肿瘤的具体情况进行不同形式的脊柱稳定性的重建。结果 围手术期无死亡病例 ,患者出院时Frankel神经功能分级 ,A级 2例 ,B级 3例 ,C级 4例 ,D级 4例 ,E级 16例。术后获访 2 3例 ,随访时间 13～ 5 8个月 ,死亡 4例 ;神经功能情况 ,13例较出院时有改善 ,加重 1例。结论 侧方入路手术途径无需经胸 /腹膜腔 ,患者容易耐受手术 ,适合于某些胸腰椎肿瘤的切除和脊柱稳定性的重建。
Objective To investigate the clinical result of thoracolumbar vertebral neoplasm resection and spine reconstruction via lateral approach. Methods 29 cases of thoracolumbar neoplasm, from T 3 to L 4, were enrolled. Neurological status was determined by Frankel grades: Grade A:3, Grade B:5, Grade C:7, Grade D:6 and Grade E:8. The anterior, posterior and lateral aspects of morbid vertebrae were exposed via lateral approach, then the neoplasms were resected, finally the spines were reconstructed differently according to lesions of the individuals. Results No patient died perioperatively. Neurological status was evaluated after operation by Frankel grades again: Grade A:2, Grade B:3, Grade C:4, Grade D:4 and Grade E:16 when they were discharged. 23 cases were followed up for 13～58 months, of which 4 died; 13 got improvement and 1 got deterioration comparing when they were discharged. Conclusion Lateral approach is a suitable method for some thoracolumbar vertebral neoplasms resection and spine column reconstruction, and easier for the patients endure without opening plural or peritoneal cavity.
出处
《临床骨科杂志》
2004年第4期382-384,共3页
Journal of Clinical Orthopaedics
关键词
脊椎肿瘤
脊柱融合术
spinal neoplasms
spinal fusion
