摘要
目的总结颈椎转移瘤的诊断与治疗经验。方法回顾性分析自2002年以来收治的15例颈椎转移性肿瘤病例资料,其中姑息性肿瘤切除、脊柱重建手术9例,椎体成形术加化疗和放疗2例,化疗加放疗4例。分析症状、体征、影像学表现、治疗方式与结果 ;评估治疗前、后症状转归、神经功能恢复、并发症。结果平均随访18.2个月。经三种治疗,颈部疼痛症状均有明显缓解,随访期间未见内固定松动。围手术期并发症2例,放射性神经炎2例。8例术前有神经根刺激症状和2例脊髓压迫症状者,术后均明显缓解。随访期间,4例因全身转移、衰竭死亡,1例因放疗剂量过大死亡,死亡前末次随访未见颈椎局部肿瘤复发。结论根据症状特点结合影像学检查,可基本明确颈椎转移性肿瘤的诊断。治疗方案的选择应遵循个体化原则,综合考虑患者的神经功能、病灶部位、总体健康状态、年龄、生活质量等多种因素。经过恰当的治疗后,生存期疼痛缓解满意,神经功能有明显恢复。
Objective To summarize the diagnosis and treating experience of cervical metastases.Methods The clinical data of 15 patients with cervical metastases in our department since 2002 were retrospectively analyzed.Nine patients underwent palliative resection and reconstructive surgery,two patients underwent vertebroplasty plus chemotherapy and radiotherapy while the other four underwent chemotherapy and radiotherapy.The symptoms,neurological status,radiology,treating strategies and results were analyzed and the symptom development,complications,neurological functional recovery before and after treatment were evaluated.Results The follow-up averaged 18.2 months with no hardware failure being observed.The cervical pain alleviated significantly by the three treatments.Minor perioperative complications and radioactive neuritis occurred in two cases respectively.Eight patients with radiculopathy and two patients with myelopathy experienced significant alleviation of neurological symptoms.During the follow-up,four patients died of multiple metastases and organ failure and one patient died of overdose of radiotherapy with no sign of local recurrence being found.Conclusion Diagnosis of cervical metastases could be made according to the characteristics of symptoms and radiological examinations.The optimal treatment should be individualized;taking into considerations of each patient＇s neurological status,focus cite,general health condition,age and quality of life etc.
出处
《局解手术学杂志》
2010年第5期362-364,共3页
Journal of Regional Anatomy and Operative Surgery
关键词
颈椎
转移性肿瘤
转移
脊柱手术
放疗
cervical spine
metastatic tumor
metastasis
spinal surgery
radiotherapy
