转移性脊髓压迫:印度北部三级保健中心的前瞻性观察研究

Pawan Kumar
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摘要

转移性脊髓压迫(MSCC)是肿瘤学中最常见的急症,如果不及时治疗或延迟治疗,可导致永久性截瘫,因此早期诊断和积极治疗以保持或改善患者的生活质量至关重要。我们分析了这些患者的事件和常见干预措施对结果的影响。材料和方法:我们对2017年未进行任何干预的80例MSCC患者进行前瞻性评估,并收集所有相关患者和疾病特征。所有患者均接受皮质类固醇治疗。手术7例,放疗59例,手术后放疗3例。结果:患者年龄以40 ~ 70岁为主,男性居多。肺癌最常见(46.25%),恶性肿瘤次之,其次为乳腺癌、骨髓瘤和前列腺癌。脊柱背部是最常见的压迫部位(50.5%),其次是腰椎(40.8%)和颈椎(8.7%)。62例(77.5%)患者表现为受累部位疼痛,60例(75%)患者表现为神经运动障碍。54例(87%)患者疼痛缓解,仅23例(38%)患者运动改善。结论:发病后7-10天出现神经功能缺损的患者与神经功能预后不良相关,但放射治疗被证明是缓解MSCC疼痛的重要方式,如果及早进行放射治疗,也有利于运动功能的保存。之前预测对治疗的反应和运动功能的总体结果。
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Metastatic Spinal Cord Compression: A Prospective Observational Study at a Tertiary Care Center of North India
Introduction: Metastatic spinal cord compression (MSCC) is a most commonly encountered emergency in oncology, that can lead to permanent paraplegia if left untreated or treatment delayed, so it is essential to diagnose early and treat aggressively to preserve or improve the patient’s quality of life. We analyzed the incident and the effect of common interventions on the outcome in these patients. Material and Methods: We prospectively evaluated 80 patients of MSCC without any intervention in the year 2017 and collected all relevant patient and disease characteristics. All patients received corticosteroids. Seven patients were operated, 59 patients treated by radiotherapy and 3 patients were treated by surgery followed by radiotherapy. Results: Most of the patients were in the age group of 40-70 years with male gender preponderance. Lung cancer was the most common incident (46.25%) malignancy followed by breast, myeloma and prostate cancer. Dorsal spine was the most common site of compression (50.5%) followed by lumbar spine (40.8%) and cervical spine (8.7%). 62 (77.5%) patients were presented with pain at affected site and 60 (75%) were presented with neurological motor deficit. 54 (87%) patients got relieved from pain and only 23(38%) patients had motor improvement after treatment. Conclusion: Patients presented 7-10 days after onset of neurological deficit were associated with poor outcome in neurological function, but radiotherapy proved an important modality for pain relief in MSCC and also beneficial in motor function preservation if instituted early. before predictive of response to treatment and overall outcome of motor functions.
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