硫酸钙骨粉混合表柔比星在脊柱转移瘤手术中的应用
王春晓;宋钦勇;陈树军;宋宏凯;张垚;田海清;谭江威;
摘要(Abstract)：
[目的]探讨硫酸钙骨粉混合表柔比星在脊柱转移瘤椎体切除手术中的临床疗效。[方法]回顾性分析本院2015年1月～2019年1月收治的16例脊柱转移瘤患者,所有患者均一期行后路椎管减压病椎切除硫酸钙骨粉混合表柔比星钛网填充前柱重建椎弓根钉内固定术。[结果]所有患者均一期完成后路手术,手术时间(292.81±40.86) min,失血量为(1 489.38±276.80) ml。术中用硫酸钙骨粉10 cm3,表柔比星10 mg。术后VAS、ODI评分明显改善(P<0.05)。ASIA分级由术前C级5例,D级5例,E级6例,改善至末次随访时D级1例,E级15例。最短生存时间为6个月,本组患者随访期间未见局部肿瘤复发。术前和术后的Cobb角比较差异无统计学意义(P>0.05)。[结论]脊柱转移瘤椎体切除手术中应用硫酸钙混合表柔比星钛网填充后前柱重建可缓解病人疼痛,改善神经功能,降低局部复发,提高生存质量。
关键词(KeyWords)： 脊柱转移瘤;硫酸钙骨粉;表柔比星;椎体切除术
基金项目(Foundation):
作者(Author): 王春晓;宋钦勇;陈树军;宋宏凯;张垚;田海清;谭江威;
Email:
DOI:
参考文献(References)：
- [1] Choi D, Crockard A, Bunger C, et al. Review of metastatic spine tumour classification and indications for surgery:the consensus statement of the Global Spine Tumour Study Group[J]. Eur Spine J,2010, 19:215-222.
- [2] Younsi A, Riemann L, Scherer M, et al. Impact of decompressive laminectomy on the functional outcome of patients with metastatic spinal cord compression and neurological impairment[J].Clin Exp Metastasis, 2020, 37(2):377-390.
- [3] Aziz NM. Trends and advances in cancer survivorship research:challenge and opportunity[J]. Semin Radiat Oncol, 2003, 13(3):248-266.
- [4] Jacobs WB. Evaluation and treatment of spinal metastases:an overview[J]. Neurosurg Focus, 2001, 11(6):e10.
- [5] Laufer I. Advances in the treatment of metastatic spine tumors:the future is not what it used to be[J]. J Neurosurg Spine, 2019, 30(3):299-307.
- [6] Derincek A, Guler UO, Uysal M. Spinal metastatic disease:survival analysis of 146 patients and evaluation of 4 different preoperative scoring systems[J]. Clin Spine Surg, 2020, 33(2):E81-E86.
- [7] Amelot A, Balabaud L, Choi D, et al. Surgery for metastatic spine tumors in the elderly. Advanced age is not a contraindication to surgery[J]. Spine, 2017, 17(5):759-767.
- [8] Padalkar P. Predictors of survival in surgically treated patients of spinal metastasis[J]. Indian J Orthop, 2011, 45(4):307-313.
- [9] Alamanda VK, Robinson MM, Kneisl JS, et al. Survival outcomes and factors associated with revision surgery for metastatic disease of the spine[J]. J Oncology, 2018, 2018:15-21.
- [10] Ishikawa S, Shin HD, Bowen JR. Is it necessary to decorticate segmentally instrumented spines to achieve fusion[J]. Spine, 1994,19(15):1686-1690.
- [11] Stepanovic Z, Ristic BM. Bacterial infections associated with allogenic bone transplantation[J]. Vojnosanit Pregl, 2015, 72:427-430.
- [12] Alamanda VK, Robinson MM, Thompson JC, et al. Necessity of bony fusion after surgical treatment of metastatic spine tumors[J].J Am Acad Orthop Surg, 2020, 1:1-9.