摘要目的 探讨下颈椎转移性肿瘤的手术治疗方法及疗效.方法 回顾性分析我院2002至2007年采用前路椎体切除减压、钛网加钛板内固定重建颈椎稳定性治疗7例下颈椎转移瘤病例.其中男3例,女4例,原发灶肺癌1例,肾癌1例,肝癌1例,胃癌2例,乳腺癌2例.比较术前和术后3个月颈部疼痛的VAS评分和神经功能Frankel分级,随访观察影像学上颈椎稳定性情况.结果 术前和术后颈部疼痛的VAS评分分别为(7.4±0.8)分和(1.8±1.2)分,两者差异有统计学意义(t=15.11,P=0.000),术后Frankel分级改善1～2级以上.1例术后9个月多脏器衰竭死亡,其余6例术后平均随访18个月,影像学检查颈椎稳定性良好.结论 前路椎体切除,钛网加钛板内固定用于治疗下颈椎转移瘤,手术能有效地缓解临床症状,充分解除脊髓压迫,改善神经功能、重建颈椎稳定性,疗效满意.

abstractsObjective To explore the surgical treatment method and outcome for subaxial cervical spine metastatic tumor. Methods We retrospectively analyzed 7 cases of subaxial cervical spine metastatic tumor treated at our hospital between 2002 and 2007. There were 3 male and 4 female patients. The primary lesions included 1 lung cancer, 1 renal cancer, 1 liver cancer, 2 gastric cancers and 2 breast cancers. All cases were treated with anterior vertebrectomy, reconstruction of cervical spine stability with mesh cage and plate fixation. Preoperative and 3-month postoperative VAS scores of neck pain and neurological status of Frankel classification were analyzed statistically. Cervical spine stability was observed by radiography during follow-up. Results The preoperative and postoperative VAS scores of neck pain were 7. 4 ± 0. 8 and 1.8 ± 1.2 respectively. There was obvious statistical difference between two scores ( t = 15. 11, P = 0. 000). The post-operative neurological status of Frankel classification improved by one to two grades. The mean followup period was 18 months except for one patient dying from multiple organ failure at 9 months post-operation. Radiology showed satisfactory cervical spine stability during follow-up. Conclusion For treating subaxial cervical spine metastatic tumor, anterior vertebrectomy, reconstruction with mesh cage and plate fixation is an effective method to relieve clinical pains and improve neurological functions by complete spinal cord decompression and cervical stability reconstruction.