Clinical Research Of Separation Surgery Combined With High-dose Radiation Therapy For Spinal Metastases

Objective:Spinal metastases are a relatively common and complicated disease.SRT is the abbreviation of stereotactic radiotherapy.It has been an important method for the treatment of spinal metastases,but due to the tolerance of the spinal cord,most treatmentsneed a gap of 2-3 mm between the tumor and the spinal cord to ensure safe irradiation,especially for high-level ESCCs,which need to be isolated between the spinal cord and the tumor,so called "separation surgery",for low-level ESCC,there is a certain safety distance between the tumor and the sipnal cord,which can be received simply posteriorlaminectomy.In this paper,two kinds of surgery combined with high-dose stereotactic radiotherapy(SRT)are used for clinical research and comparison.Methods:A retrospective analysis of 45 patients with spinal metastases,including Qilu Hospital of Shandong University and Zibo Central Hospital from January 2014 to December 2016,which was divided into "separation surgery" experimental group and"simple posterior laminectomy" control group according to ESCC classification.There are 20 patients in the experimental group and 25 patients in the control group.Both groups were combined with high-dose stereotactic radiotherapy(8gy,3 times).Analysis of Frankel score?KPS score?Vas score of two groups of preoperation and postoperation six months later.Results:After comparison,it can be clearly seen that the effect of decompression on the spinal cord obtained by the separation surgery is basically the same as that of the simple posterior laminectomy.The neurological function was improved in the control group of 25 patients with simple posterior laminectomycombined with high-dose SRT,the pain was also improved.In the experimental group,20 patients were treated with separation surgery combined with high-dose SRT,nerve function and pain have also improved.they are all achieving better results,the patients not only reduced the pain,but also greatly reduced the difficulty of SRT,providing enough space for the treatment of SRT.Conclusion:Surgical assisted SRT has become one of the important treatments for spinal metastases.The effect of separation surgery combined with high-doseSRT in high-grade ESCC patients and that of simple posterior laminectomy combined with high-doseSRT in low-grade ESCC patients basically have same results and will be better recognized and applied in the future.