- 期刊
Surgery of Pathological Fracture in Metastatic Cervical Spinal Tumor with PMMA and Titanium Rod
使用人工骨泥及鈦金屬桿做為前固定物來治療轉移性頸脊椎病理性骨折
摘要
對於轉移性頸脊椎病理性骨折造成嚴重頸椎痛及神經障礙之患者，傳統手術是前位頸椎體切除，使用自體骨移植及使用鋼板固定。今作者使用人工骨泥和鈦金屬桿做椎體固定物。 從2000年1月至20002年12月間，有6位病患符合手術適應症且接受此手術，術前或術後大都接受3060至4600雷得之放射治療。平均追蹤10個月，術後疼痛指數（VAS）平均進步4分，且神經功能指數（Flankel's grade）有2位病人進步1分。此外，沒有病人之神經功能因手術而惡化，亦沒有人工骨泥、鈦金屬桿及取骨處之併發症。所以，此方法安全、可重建及維持椎體穩定度，亦是另一種改善癌症病人之生活品質的治療方式。
關鍵字
無資料並列摘要
Objective: To assess clinical outcome and survival of patients with cervical spinal malignancies after undergoing anterior decompression and stabilization by replacement of the affected vertebral bodies with titanium rod and methylmethacrylate (MMA) polymerized in situ without any anterior cervical plate fixation. The use of a titanium rod can avoid MMA dislodging and is cost effective in those patients. Materials and Methods: From January, 2000 to December, 2002, there were six patients who matched these criteria and underwent operation. Preoperatively, all patients had severe neck pain, which aggravated with any motion of the spine. Five patients had mild to moderate neurological deficit. All patients received palliative radiotherapy to the involved vertebrae either preoperatively or postoperatively with a dosage ranging from 3060 to 4600 rads. Postoperatively, all patients wore a hard cervical collar. The periods of postoperative follow-up were 3 to 30 months. Results: Most of the patients reported decrease in neck pain and the median change of pre- and post-operative VAS score was -4 (paired-t test; p=0.00096125). No patients had deteriorated neurological status. There were no complications associated with the rod and PMMA. Of course, there were also no donor-site-associated complications. Conclusions: MMA polymerizing in situ anchored by a titanium rod is a safe and effective surgical procedure, re-creating and maintaining normal vertebral alignment and stability. It is also an alternative treatment to improve the quality of life for cancer patients.
延伸閱讀
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