脊柱骨巨细胞瘤的手术治疗及术后复发的相关因素分析-骨外科专业论文.docx

SurgicalTreatmentandRiskFactors forRecurrenceof GiantCellTumorof SpineAbstractPartⅠSurgicalTreatmentofGiantCellTumorsoftheSpine CombinedwithPreoperativeTransarterialEmbolizationObjective:Toinvestigatetheefficacyofsurgicalexcisionwithpreoperative transarterialembolizationforthegiantcelltumorofspine.Methods:BetweenJune1995andAugust2011,28patientswithgiantcelltumorof thespinewereinterviewedretrospectively.Therewere12malesand16femaleswiththe averageageof29.6years (range:11~58years).15cases werelocatedinthesacrumand13 inthemobilespine(8thoracicand5lumbar).Mostpatientspresentedwithpainatthesite oftumorinvolvementbeforesurgery.17patientsexistedneurologicdeficit,and8cases hadboweland/orbladderdysfunction.Allthepatientswereoperated1to2daysafter transcatheterarterialembolization. Theintraoperativebloodlossandtransfusionwere reviewed.Thelocalrecurrence,complications,follow-upstatusandfunctionaloutcome wereobserved.Results:Therewerenosymptomaticcomplications associatedwithembolization,and allthepatientsweretreatedwithintralesionalexcisionafterpreoperativetransarterial embolization.Therewerenoperioperativedeaths.Theaverageintraoperativebloodloss was1528.6mL(range:400~5800mL),andtheaveragetransfusionvolumewas1514.3mL (range:400~6000mL).Theanteriorapproachwasusedfor8cases,posteriorapproachwas usedfor18cases,andcombinedanteriorandposteriorapproachwasusedfor2cases. Therewere 14(50%)patientsunderwent reconstruction,and6(21.4%)patientswere treatedpostoperativelywithadjuvantradiationtherapy.Theaveragefollow-upwas86.5 months(range:16-193months).Eight(28.6%)patientsdevelopedrecurrenceandtwo (7.1%)patientsdied.Eight(28.6%)patientsexperiencedcomplicationsperioperativelyor duringthefollow-up,six(21.4%)patientshadwoundcomplications,onepatient experiencedcerebrospinalfluidleakageandonethoracicpatientdevelopedkyphosis.The 14patientswhounderwentreconstructiondidnotexperiencehardwarefailurerequiringAbstractSurgicalTreatmentandRiskFactorsforRecurrenceofGiantCellTumorofSpinesurgicalrevision.Twenty