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目的 应用不同的脊柱固定方法探讨脊柱肿瘤切除后的功能重建。方法15 例脊柱肿瘤切除术中应用前路肿瘤切除及固定13 例,前后路联合切除及后路固定2 例,其中Kaneda 固定器加骨水泥及植骨10 例;克氏针骨水泥固定3 例;Steffee 钢板加骨水泥及植骨各1例。结果 术后1 周11 例能支撑坐起,2 周9例在保护下可下地行走,3个月时13例恢复行走功能;术后2 个月12 例疼痛消失,2 例减轻;术后1 例因骨髓抑制死亡。4 例转移癌分别在术后3 个月～1 年死亡,随访3～20 个月效果满意。结论 脊柱肿瘤切除后应用骨水泥或植骨加内固定物可使脊柱早期恢复负重功能,减轻疼痛,利于神经功能的恢复,而采用前路术式以Kaneda 固定器,后路术式以Steffee固定器较为理想
Objective To explore the functional reconstruction of spinal tumor after resection using different spinal fixation methods. Methods Fifteen cases of spinal tumor resection were treated with anterior tumor resection and fixation in 13 cases, anterior and posterior approach combined resection and posterior fixation in 2 cases, including Kaneda fixture plus cement and bone graft in 10 cases; Kirschner needle cement fixation in 3 cases. Steffee plate plus bone cement and bone graft in 1 case. Results 11 cases were able to support and sit up in the first postoperative week, 9 cases were able to walk under protection in 2 weeks, and 13 cases resumed walking function at 3 months; 12 cases of pain disappeared in 2 months and 2 cases decreased after 2 months; He died of bone marrow suppression. Four cases of metastatic carcinoma died 3 months to 1 year after operation. The follow-up of 3 to 20 months was satisfactory. Conclusion The application of bone cement or bone graft plus internal fixation after spinal tumor resection can restore weight-bearing function in the early stage of the spine, relieve pain, and facilitate the recovery of nerve function. Anterior approach is used for Kaneda fixation, and posterior approach is stabilized with Steffee. The ideal