转化医学杂志2025，Vol.14Issue(6)：1-6,6.DOI:10.3639/j.issn.2095-3097.2025.06.001
立体定向放疗联合经皮椎弓根螺钉置入及椎体成形术或分离手术治疗胸腰椎脊柱转移瘤的疗效观察
Effect of Stereotactic Radiotherapy Combined with Percutaneous Pedicle Screw Fixation and Vertebroplasty versus Separation Surgery in the Treatment of Thoracolumbar Spinal Metastases
摘要
Abstract
Objective To investigate the clinical effects of stereotactic radiotherapy combined with percutaneous pedicle screw(PPS)+percutaneous vertebraplasty(PVP)or separation surgery in the treatment of thoracolumbar spinal metas-tases.Methods This study retrospectively analyzed the clinical data of 83 patients with thoracolumbar spinal metastases who underwent elective surgical treatment at the 5th Medical Center of PLA General Hospital between May 2016 and May 2021.Patients were divided into group A(stereotactic radiotherapy combined with PPS+PVP,37 patients)and group B(stereotactic radiotherapy combined with separation surgery,46 patients)based on different surgical methods.Pain,vertebral function recov-ery,neurological function,and quality of life were compared between the two groups at multiple time points.There-year survival rates and overall survival were also analyzed.Results The visual analogue scale(VAS)scores,Oswestry disability index(ODI)scores,Frankel neurological function scores,and Karnofsky performance status(KPS)scores differed between the two groups at different time points(P<0.05).Group A had significantly lower VAS scores than group B at 1 week,1 month,3 months,and 6 months postoperatively(P<0.05).Group A had significantly higher ODI scores and significantly lower Frankel neurological function scores than group B at 6 and 12 months postoperatively(P<0.05).The KPS scores showed no significant differences be-tween the two groups at all time points(P>0.05).There were no significant differences in the 3-year survival rate,overall survival,tumor recurrence rate,or metastasis rate during follow-up between the two groups(P>0.05).Conclusion Stereotactic radiothera-py combined with separation surgery achieves better effects than stereotactic radiotherapy combined with PPS+PVP in promoting vertebral function recovery and in relieving spinal nerve compression.However,separation surgery is inferior for pain relief.关键词
胸腰椎脊柱转移瘤/立体定向放射治疗/经皮椎弓根螺钉置入/经皮椎体成形术/分离手术/临床疗效Key words
Thoracolumbar spinal metastasis/Stereotactic radiotherapy/Percutaneous pedicle screw/Percutaneous ver-tebroplasty/Separation surgery/Clinical effect分类
医药卫生引用本文复制引用
江宁,郭钧,刘铖,郭玮,郝志亚..立体定向放疗联合经皮椎弓根螺钉置入及椎体成形术或分离手术治疗胸腰椎脊柱转移瘤的疗效观察[J].转化医学杂志,2025,14(6):1-6,6.基金项目
国家自然科学基金(3167080224) （3167080224）
