転移性脊椎腫瘍に対するPalliative Surgeryの治療成績

Clinical Results of Palliative Surgery for Metastatic Spinal Tumors

　抄録：転移性脊椎腫瘍に対するpalliative surgeryの術後成績を検討した．対象は1995年以降麻痺を来した35例39手術で，転移部位は頚椎6例，胸椎19例，腰椎14例であった．疼痛は全例改善し，麻痺は51％，移動能力は54％で改善した．術前Frankel B，C例や胸椎，腰椎転移例では高い改善が得られた．出血対策として術前の塞栓療法，低血圧麻酔，神経除圧に先立つinstrumentationの設置が有効であった．Palliative surgeryは疼痛，麻痺，移動能力の改善の観点から有効な方法であった．

　The postoperative results in 35 cases of metastatic spinal tumor treated by palliative surgery since 1995 were evaluated. The spinal metastasis was at the cervical level in six cases, the thoracic level in 19 cases, and the lumbar level in 14 cases. All patients experienced pain relief；51％ recovered from their paralysis, and 54％ had improved ability to movement their lower extremities. Significant recovery from paralysis was achieved especially in the Frankel B or C cases and the cases with thoracic or lumbar metastasis. Embolization, hypotensive anesthesia, and setting up instrumentation before laminectomy are useful in preventing bleeding.

　The palliative surgery for metastatic spinal tumors was effective and valuable from the standpoint of improving the quality of life of patients with difficulty walking, severe pain, and progressive paralysis.