目的 探讨肿瘤椎体切除人工椎体置换脊柱重建的有关问题 。方法 分析5例手术治疗的临床资料；复习国内文献资料。结果 5例术后6～12个月重建椎体骨性融合，其中1例前列腺癌术后26个月死于肺转移 。国内文献32例，1例术后3天死于心衰和肺部感染；31例重建椎体骨性融合，其中3例螺钉 松动。结论 肿瘤椎体切除，采用人工椎体置换可重建脊柱支撑；不管椎 体肿瘤是原发还是转移，凡能耐受手术者均应尽早手术；假体内外植骨才能牢固融合；术前 节段性椎动脉栓塞，术中采用控制性低血压，可减少出血量。%Objective To explore some asp ect s conce rning the removal of tumorous vertebra and prosthetic replacement for spinal reconstruction. Methods Analysis of clinical data o f 5 cases and review of domestic documentation. Results All 5 cases obtained spinal fusion 6～12 months after operation. Among them, one case of postatic carcinoma died from pulmornary me tastasis 26 months after operation. Among domestic documentation of 32 cases except for one patient died of heart failure and lung infection , the other 31 cases were followed up for different time span and a chieved spinal fusion, screw of 3 cases loosened. Conclusion After radical resection of the tumor, the insertion of a prosthetic vertebral can reestablish spinal stability. Either primary or metastati c vertebra tumors, all patients should receive operation as soon as pos sible when physical condition allowed. Bone grafting within and around the prosthetic vertebra can provide osseous spinal stability. Preoperati ve vertebra arterial embolization and keeping low blood pressure during operation can reduce bleeding.
展开▼
