Posterior Decompression Internal Fixation With Vertebroplasty For The Treatment Of Thoracic And Lumbar Metastatic Tumors With Neurological Symptoms

Objective: To investigate the short-term clinical efficacy of posterior decompression internal fixation with vertebroplasty for the treatment of thoracic and lumbar metastatic tumors with neurological symptoms.Methods:From January 2015 to June 2017,24 patients with thoracic and lumbar spine metastasis who had neurological symptoms were treated.There were 16 males and 8 females;aged 38 to 84 years with a mean age of 57 years old;18 patients were involved in a single vertebral body,3 Cases involved 2vertebral bodies,2 cases involving 3 vertebral bodies,1 case involving 4vertebral bodies,11 cases involving the thoracical vertebral body,and 15 cases involving the lumbar vertebral body(2 cases involving thoracical and lumbar vertebral body).The operative time,intraoperative blood loss and postoperative hospital stay were recorded.The VAS score,ECOG score and ASIA classification were used to evaluate the pain,functional status and spinal cordfunction.X-ray was used to measure the changes of the anterior and the central vertebral height of the diseased to evaluate the stability of the spine.Kaplan-Meier method was used to assess survival.Follow-up observation of tumor recurrence and complications.Results:All patients were followed up for an average of 11 months.The average time of operation was 2.15 hours.The average blood loss during the operation was 727.08 ml,and the average length of hospital stay was 5.46 days.The vertebral body height of anterior and central in X-ray was significantly higher than that before surgery(P<0.05).Postoperative VAS scores and ECOG scores were significantly lower than that before surgery,and the patients' pain relief and functional status improved significantly.The difference was statistically significant(p<0.05).According to the ASIA,24 patients had a certain improvement,and there was a statistically significant difference between preoperative and postoperative(p<0.05).No serious complications were seen after surgery.Patients who undergo postoperative chemoradiation have a longer survival time than those who did not.Conclusion:The posterior decompression internal fixation combined with vertebroplasty for the treatment of thoracic and lumbar metastatic tumors with neurological symptoms is relatively simple,with few complications,It can safely and effectively improve the patients' quality of life.