摘要
[目的]探讨骶骨肿瘤术前选择性数字减影血管造影（DSA）血管栓塞，肿瘤切除术后前路用重建钢板加骨水泥和（或）联合后路钉棒系统重建脊柱和骨盆稳定性的疗效。【方法】骶骨肿瘤19例，术前均采用选择性DSA血管栓塞、术中尽可能保留S1～S3神经，肿瘤切除后前路用重建钢板加骨水泥和（或）联合后路钉棒系统重建骨盆稳定性。【结果】随访6～52个月，所有患者均安全度过围术期，4例因复发及远处转移分别于术后12个月、14个月、20个月及36个月死亡，13例患者腰骶部疼痛及神经功能有不同程度改善，其中7例恢复正常负重及行走，2例术后6个月失访。13例重建者随访期间X线片检查见所有病例骨盆稳定性好，无腰椎下沉及移位，亦无骨水泥脱落。【结论】术前选择性DSA血管栓塞止血效果好，骶骨肿瘤切除术后前路用重建铜板加骨水泥和（或）后路钉棒系统联合重建脊枉和骨盆稳定性的疗效可靠。
Objective To investigate the outcomes of sacral tumors treated by selective vascular embolization with digital subtraction angiography （DSA） before operation and reconstructive plate combined with bone cement by anterior approach and/ or screw stick system by posterior approach used for reestablishing the stability of spine and pelvis after tumorectomy. [Methods] Nineteen patients with sacral tumor in our department were treated by selective vascular embolization with DSA before operation, and the S1-S3 sacral nerves were reserved as far as possible during the operation. After tumorectomy, reconstructive plate and bone cement were used by anterior approach and/or screw stick system by posterior approach for establishing the stability of the spine and pelvis. [Results]The follow up was 6-52 months, and all the patients survived in the period of operation. Four cases died of recurrence and distant metas- tasis in 12 months, 14 months, 20 months and 36 months after operation. The pain in lumbosacral area and nerve functions were improved in different levels in 13 cases, and 7 of them had the recovery of normal weight loading and walking, Two cases lost follow up in 6 months. In the follow up period, Xrays showed that the stability of pelvis was fine in all the patients, and there were no lumbar subsidence and displace or bone cement deluvium in 13 cases with pelvis reconstruction. [Conclusion]The selective vascular embolization by DSA before operation has good effect of hemostasis. Reconstructive plate combined with bone cement by anterior approach and/or screw stick system by posterior approach after tumorectomy for reestablishing the stability of the spine and pelvis has reliable short term effi cacy.
出处
《医学临床研究》
CAS
2009年第4期581-584,共4页
Journal of Clinical Research
