脊柱转移性肿瘤的评分和局部治疗

摘要

The clinical classification of metastatic spinal tumors is based on the degree of malignancy, nervous system function, osteoclasia, and prognosis of patients. The application of this classification system is relatively simple. The assessment and evaluation of patients to estimate the period of survival can guide the individualized treatment of patients. Patients with clear surgical indications can choose to undergo a palliative operation, tumor resection, or total spondylectomy. Alternatively, other patients can opt to have mini-mally invasive surgery aside from the normal surgical approach. Stereotactic radiotherapy and intensity-modulated radiation therapy combined with the use of radiofrequency ablation, radiation, and other therapies can achieve local tumor control, relieve pain, and main-tain normal neurological function. Thus, the quality of life of the patient is improved. Percutaneous vertebroplasty, radiofrequency abla-tion, spinal endoscopy, and other modern forms of minimally invasive surgery will have more applications in the treatment of spinal metastatic tumors.%　　脊柱转移瘤的分类评分方法基于肿瘤的恶性程度、患者的神经系统功能、骨破坏情况及预后，评价简单适用，预测性较强。进行预计生存期评估和系统评价，可以指导患者的个体化治疗，明确具有手术适应证的患者可以通过姑息手术、瘤内切除或全脊椎切除术，或选择合适的微创手术方式和入路，结合采用立体定向放射治疗和调强放射治疗等措施，达到肿瘤局部控制、维持神经功能，改善生存质量的目的。经皮椎体成形术、射频消融、脊柱内窥镜等现代微创外科理念和技术将在脊柱转移性肿瘤治疗方面发挥更大的作用。