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首页> 外文期刊>British journal of neurosurgery >The surgical management of metastatic spinal disease: prospective assessment and long-term follow-up.
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The surgical management of metastatic spinal disease: prospective assessment and long-term follow-up.

机译：转移性脊柱疾病的外科治疗：前瞻性评估和长期随访。

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The last decade has witnessed a resurgence of interest in the surgical treatment of metastatic spinal disease to compliment radiotherapy. A recent randomized controlled trial looking directly at this issue concluded strongly in favour of a combination of surgical decompression and radiotherapy, and there is now growing enthusiasm for surgery to play a role in the management of these patients. We present a prospective cohort study of 62 patients who presented with metastatic cord or cauda equina compression, and were treated with surgical decompression and fixation where necessary. Patients were treated by one surgeon working in a single unit. They were followed-up long term and were assessed objectively, by clinical assessment and prospective questionnaires that included SF36, visual analogue pain scores and Roland Morris back pain scores. Sixty-two patients with a median age of 62 (22-79 years, 27 male) were included in the study. The commonest primary tumours were breast (26%) and lymphoma (13%). Themajority of patients had involvement of thoracic vertebrae (58%). 56% of patients were alive at 1 year and 28% at 3 years, with significant improvements observed in both walking and continence. Similarly, significant improvements were seen in SF36 quality of life scores as well as pain. With careful patient selection, long-term survival and good quality of life can be achieved. However, not every patient is suitable or appropriate for surgery, and the discussion focuses on where the surgical threshold should be set.
机译：在过去的十年中，人们对转移性脊柱疾病的外科治疗以补充放射疗法的兴趣重新兴起。一项直接针对此问题的随机对照试验最近得到了强烈支持，将手术减压和放疗相结合，结果表明，对于在这些患者的治疗中发挥作用的手术，人们的热情越来越高。我们提供了一项前瞻性队列研究，该研究对62例行转移性脐带或马尾动脉压迫并在必要时进行手术减压和固定的患者进行了研究。一名外科医生在一个单元中工作，对患者进行了治疗。他们进行了长期随访，并通过临床评估和前瞻性问卷进行了客观评估，包括SF36，视觉模拟疼痛评分和Roland Morris背痛评分。该研究纳入了62位中位年龄为62岁的患者（22-79岁，男27位）。最常见的原发性肿瘤是乳腺癌（26％）和淋巴瘤（13％）。大多数患者累及胸椎（58％）。 56％的患者在1年时还活着，在3年时则是28％，行走和节制方面都有显着改善。同样，在SF36生活质量评分和疼痛方面也看到了明显的改善。通过精心选择患者，可以实现长期生存和良好的生活质量。但是，并非每个患者都适合或适合手术，因此讨论重点是应该在哪里设定手术阈值。

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