| 姚福东,罗鹏明,刘夏君.脊柱转移性肿瘤患者脊柱手术后早期相邻节段性疾病发生的分级评估[J].肿瘤学杂志,2019,25(2):140-144. |
| 脊柱转移性肿瘤患者脊柱手术后早期相邻节段性疾病发生的分级评估 |
| Assessment of Early Adjacent Segmental Disease in Patients after Spinal Surgery with Tumor Metastases |
| 投稿时间：2017-08-11 |
| DOI：10.11735/j.issn.1671-170X.2019.02.B012 |
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| 中文关键词: 脊柱转移性肿瘤 邻近节段疾病 Oner分型诊断标准 Pfirrmann分级 |
| 英文关键词:spinal metastatic tumor adjacent segmental disease Oner criteria Pfirrmann criteria |
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| 中文摘要: |
| 摘 要：［目的］ 评估脊柱转移性肿瘤患者接受脊柱固定术后早期发生相邻节段疾病(adjacent segmental disease，ASD)的情况。［方法］ 回顾性分析收治的241例脊柱肿瘤患者，208例（86.3%）患者接受手术治疗，167例患者完成术后12个月的MRI和临床检查随访。根据手术方式的不同，将患者分为7组，并通过基于MRI结果的Oner分型标准和Pfirrmann分级标准诊断手术患者术后12个月内ASD发生率，并比较2种诊断标准对脊柱转移瘤术后ASD的诊断差异。［结果］ 根据Oner分型标准诊断ASD的发生率为11.4%，Pfirrmann分级标准诊断ASD的发生率为24.0%，两者对ASD的诊断差异有统计学意义（P<0.001），但不同手术方式患者间两种诊断标准对ASD的诊断无明显差异（P均>0.05）。基于临床症状诊断ASD的发生率为3.6%，显著低于Oner和Pfirrmann诊断标准（P=0.007、0.002）。脊柱稳定性7～9级的患者术后ASD发生率高于脊柱稳定性4～6级的患者（29.9% vs 15.7%，P=0.034）。［结论］ 基于影像学检查结果对脊柱转移性肿瘤患者术后早期发生ASD的诊断价值优于临床症状诊断标准，其中Pfirrmann分级标准的诊断敏感性高于Oner分型标准。 |
| 英文摘要: |
| Abstract：［Objective］ To assess the adjacent segmental disease(ASD) after spinal surgery in patients with spinal metastatic tumor. ［Methods］ The data of 241 patients with spinal metastatic tumor admitted between January 2006 and December 2012 were analyzed retrospectively. Two hundred and eight patients(86.3%) underwent surgical treatment，of whom 167 cases(80.3%) were followed up with MRI and clinical examination for 12 months after surgery. The incidence of ASD was assessed with Oner criteria and Pfirrmann criteria based on MRI images after 12 months of follow up. The incidence of ASD according to the two different diagnostic systems was compared. ［Results］ The incidence of ASD based on Pfirrmann criteria was higher than that based on Oner criteria(24.0% vs 11.4%，P<0.001). There was no significant difference in diagnosis of ASD with two criteria among different surgical modalities(P>0.05). The incidence of ASD based on clinical examination was 3.6%，significantly lower than that under the Oner and Pfirrmann criteria(P=0.007， 0.002). Patients with spinal stability level 7～9 were more likely to develop ASD at early stage after surgery than patients with spinal stability level 4～6(29.9% vs 15.7%，P=0.034). ［Conclusion］ The diagnosis of ASD based on imaging is superior to that based on clinical examination，and the diagnostic sensitivity of the Pfirrmann criteria is higher than that of the Oner criteria. |
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