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Contributors to authors 作者投稿
Q4 Medicine
Seminars in Spine Surgery
Pub Date : 2024-11-26 DOI: 10.1053/S1040-7383(24)00070-4
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引用次数: 0
Operative and non-operative options for benign primary spine tumors 良性原发性脊柱肿瘤的手术和非手术治疗方案
Q4 Medicine
Seminars in Spine Surgery
Pub Date : 2024-11-06 DOI: 10.1016/j.semss.2024.101139
Ikechukwu C. Amakiri , Daniel G. Tobert
Benign primary spinal tumors (BPST) are rare entities with significant diagnostic and therapeutic challenges. These tumors can originate from the various mesenchymal tissues that compose the spinal column. They are typically classified using the Enneking or Weinstein-Boriani-Biagini (WBB) classifications, which guide surgical planning and intervention. The most frequent benign spinal tumors include osteoblastoma, osteoid osteoma, osteochondroma, giant cell tumors, aneurysmal bone cysts, hemangiomas, and Langerhans cell histiocytosis. Treatment options vary from nonoperative therapies such as analgesics, radiotherapy, and tumor ablation, to surgical interventions ranging from intralesional curettage to en bloc resection. The choice of treatment depends on factors such as tumor type, location, and potential for recurrence. A multidisciplinary approach, involving orthopedic surgeons, oncologists, and radiologists, is crucial for optimizing patient care. This review aims to provide concise information for the operative and nonoperative treatments of the most common extramedullary primary benign spinal tumors.
良性原发性脊柱肿瘤（Benign primary spinal tumors，BPST）是一种罕见的肿瘤，在诊断和治疗方面都存在很大的挑战。这些肿瘤可起源于构成脊柱的各种间质组织。这些肿瘤通常采用恩耐金（Enneking）或韦恩斯坦-博里亚尼-比亚吉尼（WBB）分类法进行分类，以此指导手术规划和干预。最常见的脊柱良性肿瘤包括成骨细胞瘤、类骨瘤、骨软骨瘤、巨细胞瘤、动脉瘤性骨囊肿、血管瘤和朗格汉斯细胞组织细胞增生症。治疗方法多种多样，既有镇痛剂、放射治疗和肿瘤消融等非手术疗法，也有从内部刮除到整体切除的手术治疗。治疗方法的选择取决于肿瘤类型、位置和复发可能性等因素。由骨科外科医生、肿瘤学家和放射科医生共同参与的多学科方法对于优化患者护理至关重要。本综述旨在为最常见的髓外原发性良性脊柱肿瘤的手术和非手术治疗提供简明信息。
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引用次数: 0
Wound complications following spine tumor surgery: Risk factors and prevention 脊柱肿瘤手术后的伤口并发症：风险因素与预防
Q4 Medicine
Seminars in Spine Surgery
Pub Date : 2024-11-04 DOI: 10.1016/j.semss.2024.101138
Chukwuka Obiofuma, Addisu Mesfin
Surgical site infections (SSI) and wound complications are common following primary and metastatic spine tumor surgery. Some risks factors include pre-operative radiation therapy, malnutrition, revision surgeries, length of surgery and co-morbidities. Some strategies to decrease wound complications include plastic surgery closure and use of betadine irrigation and vancomycin intrawound power. However, larger series prospective randomized studies are needed in order advance the field of spine oncology and to continue to decrease wound complications.
手术部位感染（SSI）和伤口并发症在原发性和转移性脊柱肿瘤手术后很常见。一些风险因素包括术前放疗、营养不良、翻修手术、手术时间长和并发症。一些减少伤口并发症的策略包括整形手术闭合、使用倍他丁冲洗和万古霉素伤口内动力。然而，为了推动脊柱肿瘤学领域的发展并继续减少伤口并发症，需要进行更大规模的系列前瞻性随机研究。
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引用次数: 0
Update on the management of extradural primary pediatric spinal tumors 硬膜外原发性小儿脊柱肿瘤的最新治疗方法
Q4 Medicine
Seminars in Spine Surgery
Pub Date : 2024-11-01 DOI: 10.1016/j.semss.2024.101140
Chukwuemeka Mbagwu, Lancelot Benn, Addisu Mesfin
Osseous/extradural pediatric spine tumors are uncommon and divided into benign and malignant. The Enneking classification is used to divide the benign tumors into latent, benign aggressive and aggressive. The malignant spine tumors include osteosarcoma, Ewing's sarcoma and lymphoma. A tissue biopsy is crucial for diagnosis and is essential to manage these tumors in a multi-disciplinary manner.
骨性/硬膜外小儿脊柱肿瘤并不常见，分为良性和恶性。根据恩耐金分类法，良性肿瘤分为潜伏性、良性侵袭性和侵袭性。恶性脊柱肿瘤包括骨肉瘤、尤文氏肉瘤和淋巴瘤。组织活检是诊断的关键，也是以多学科方式处理这些肿瘤的关键。
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引用次数: 0
Interventional radiology procedures for metastatic spine tumors 治疗转移性脊柱肿瘤的介入放射学程序
Q4 Medicine
Seminars in Spine Surgery
Pub Date : 2024-10-31 DOI: 10.1016/j.semss.2024.101135
Lauren Park , Nora Tabori , John Smirniotopoulos

Objective

Interventional radiology procedures can offer locoregional tumor control and palliative options for patients with metastatic disease to spine to relieve pain, to delay neurologic deficits, and to improve quality of life and daily function.

Findings

Multiple thermal energies for percutaneous ablation of metastases to the spine exist and are chosen according to tumor characteristics, volume, and location. Vertebral augmentation is most often combined with ablation for structural stability. Intravascular embolization of metastases provides tumor palliative or presurgical devascularization.

Conclusion

Ablation, vertebral augmentation, and intravascular embolization are efficacious minimally invasive options for the management of spinal tumors.
目的介入放射学手术可为脊柱转移性疾病患者提供局部肿瘤控制和姑息性选择，以缓解疼痛，延缓神经功能缺损，改善生活质量和日常功能。研究结果脊柱转移瘤经皮消融术存在多种热能，可根据肿瘤特征、体积和位置进行选择。椎体增强术通常与消融术相结合，以确保结构的稳定性。结论消融术、椎体增强术和血管内栓塞术是治疗脊柱肿瘤的有效微创选择。
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引用次数: 0
Advanced radiation therapy options for primary and metastatic spine tumors 原发性和转移性脊柱肿瘤的先进放射治疗方案
Q4 Medicine
Seminars in Spine Surgery
Pub Date : 2024-10-28 DOI: 10.1016/j.semss.2024.101136
Akrita Bhatnagar , Timothy Kearney , Susan M. Woody, Keith R. Unger, Matthew E. Witek
Primary spinal cord and metastatic spine tumors represent a heterogenous group of malignancies whose management is complex given the variety of tumor histologies, tumor-related morbidity, and potential complications of treatment. The critical role of radiation therapy in the management of primary spinal cord and metastatic spine tumors has been influenced by advances in neurosurgical techniques, neuroimaging, integrative diagnoses, and most impactfully through advances in radiotherapy technology specifically stereotactic radiotherapy and proton therapy. This article reviews contemporary literature supporting the use of advanced radiotherapy in the management of primary spinal cord and metastatic spine tumors.
原发性脊髓肿瘤和转移性脊柱肿瘤是一组异质性恶性肿瘤，由于肿瘤组织学、肿瘤相关发病率和治疗潜在并发症的多样性，其治疗非常复杂。放疗在治疗原发性脊髓肿瘤和转移性脊柱肿瘤中的关键作用受到神经外科技术、神经影像学、综合诊断等方面的进步的影响，其中最有影响力的是放疗技术的进步，特别是立体定向放疗和质子治疗。本文回顾了支持在原发性脊髓肿瘤和转移性脊柱肿瘤治疗中使用先进放疗的当代文献。
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引用次数: 0
Management of intradural extramedullary and intramedullary spinal tumors 硬膜外髓内和髓内脊柱肿瘤的管理
Q4 Medicine
Seminars in Spine Surgery
Pub Date : 2024-10-28 DOI: 10.1016/j.semss.2024.101141
Amanda Roehrkasse, Jeffrey Breton, Jean-Marc Voyadzis
Intradural spine tumors are relatively uncommon and include tumors outside (extramedullary) or within the spinal cord (intramedullary). The proximity of these tumors to important neural structures can cause significant neurologic morbidity and prompt management is critical for maintaining function. Surgical intervention is generally the primary treatment depending on presenting symptoms, radiologic features, and the likelihood of a clear surgical planes vis-à-vis the spinal cord. Adjuvant radiation, chemotherapy, or other novel therapeutic strategies may play a role in postoperative management. Here we review management strategies for common intradural extramedullary (meningiomas, schwannomas, and neurofibromas) and intradural intramedullary tumors (astrocytomas, ependymomas, and hemangioblastomas).
脊髓硬膜内肿瘤相对少见，包括脊髓外（髓外）或脊髓内（髓内）肿瘤。这些肿瘤靠近重要的神经结构，可导致严重的神经系统发病，因此及时治疗对维持功能至关重要。手术干预通常是主要的治疗方法，具体取决于表现症状、放射学特征以及与脊髓相邻的清晰手术平面的可能性。辅助放疗、化疗或其他新型治疗策略可能会在术后管理中发挥作用。在此，我们回顾了常见的硬膜外髓内肿瘤（脑膜瘤、分裂瘤和神经纤维瘤）和硬膜内髓内肿瘤（星形细胞瘤、上皮瘤和血管母细胞瘤）的治疗策略。
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引用次数: 0
Minimally invasive management of metastatic spine tumors 微创治疗转移性脊柱肿瘤
Q4 Medicine
Seminars in Spine Surgery
Pub Date : 2024-10-28 DOI: 10.1016/j.semss.2024.101134
Atousa Nourmahnad , Matiar Jafari , Thomas E Olson , Andrew C. Vivas , Elizabeth L. Lord
Minimally invasive spine surgery is primed for innovation and development. As imaging and navigations modalities continue to develop, their impact on clinical outcomes and patient quality of life is expected to be substantial, marking a significant step forward in neurosurgical practice. By combining these advanced technologies with minimally invasive surgical approaches and adjuvant therapies, we are bound to significantly improve patient outcomes, minimize neurological deficits, and enhance the overall quality of life for patients with spinal tumors.
脊柱微创手术正处于创新和发展的黄金时期。随着成像和导航模式的不断发展，它们对临床疗效和患者生活质量的影响预计将是巨大的，标志着神经外科实践向前迈出了重要一步。通过将这些先进技术与微创手术方法和辅助疗法相结合，我们必将显著改善患者的治疗效果，最大限度地减少神经功能缺损，并提高脊柱肿瘤患者的整体生活质量。
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引用次数: 0
Overview and management of sacral tumors 骶骨肿瘤概述和治疗
Q4 Medicine
Seminars in Spine Surgery
Pub Date : 2024-10-28 DOI: 10.1016/j.semss.2024.101142
Douglass C. Johnson , S. Mohammed Karim , Addisu Mesfin
Sacral tumors can range from benign to malignant. The sacrum is a common site of metastases however surgical intervention is not common for sacral metastases unless there is neurological compromise. Benign aggressive tumors such giant cell tumors, osteoblastomas and aneurysmal bone cysts (ABC) can be found in the sacrum. Malignant primary tumors including chordoma, chondrosarcomas and osteosarcomas can affect the sacrum. Management depends on the tumor histology including debulking and stabilization for metastatic spine lesions. For benign tumors such as ABCs, intralesional resection is an option. For primary spine tumors partial or total sacrectomies are an option and morbidity is dependent on the level of sacral resection.
骶骨肿瘤有良性和恶性之分。骶骨是常见的转移部位，但除非出现神经系统损害，否则手术治疗骶骨转移瘤并不常见。骶骨中可发现良性侵袭性肿瘤，如巨细胞瘤、成骨细胞瘤和动脉瘤性骨囊肿（ABC）。包括脊索瘤、软骨肉瘤和骨肉瘤在内的恶性原发性肿瘤可影响骶骨。治疗方法取决于肿瘤组织学，包括对转移性脊柱病变进行清创和稳定治疗。对于ABC等良性肿瘤，可选择行腔内切除术。对于原发性脊柱肿瘤，可选择部分或全部骶骨切除术，发病率取决于骶骨切除的程度。
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引用次数: 0
Total en bloc spondylectomy for primary tumors of the thoracic and lumbar spine: A review article 胸椎和腰椎原发性肿瘤的全脊椎切除术：综述文章
Q4 Medicine
Seminars in Spine Surgery
Pub Date : 2024-10-28 DOI: 10.1016/j.semss.2024.101137
Takaki Shimizu , Satoshi Kato , Noriaki Yokogawa , Takaaki Uto , Yuji Ishino , Kazuhiro Nanpo , Megumu Kawai , Hideki Murakami , Satoru Demura
Primary spine tumors present significant clinical challenges due to their potential for local invasiveness and metastasis. Total en bloc spondylectomy (TES) has emerged as a feasible surgical technique for the complete resection of thoracic and lumbar spinal tumors, providing superior local control and long-term survival benefits. This review synthesized the current evidence and clinical experiences and demonstrated that TES achieved lower recurrence rates and higher disease-free survival than those of piecemeal resection. Despite the high perioperative complication rates, TES is essential for treating primary spine tumors. The importance of skilled surgical teams to optimize patient outcomes has been emphasized.
原发性脊柱肿瘤由于其潜在的局部侵袭性和转移性，给临床带来了巨大挑战。全脊椎整体切除术（TES）已成为彻底切除胸椎和腰椎肿瘤的可行手术技术，可提供出色的局部控制和长期生存优势。这篇综述综合了当前的证据和临床经验，证明 TES 比零碎切除术的复发率更低，无病生存率更高。尽管围手术期并发症发生率较高，但TES对于治疗原发性脊柱肿瘤仍是必不可少的。熟练的手术团队对优化患者预后的重要性已得到强调。
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