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STUDY OF EARLY DETECTION, ASSESSMENT OF DISEASE PROGRESS AND SURGICAL MANAGEMENT IN METASTATIC CANCER OF THE SPINE

脊柱转移癌的早期检测、疾病进展评估和手术治疗的研究

基本信息

批准号：
63480341
负责人：
ONO Keiro
金额：
$ 3.39万
依托单位：
OSAKA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1988
资助国家：
日本
起止时间：
1988 至 1989
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-63480341/
关键词：
MALIGNANT TUMOR SPINAL METASTASIS BONE SCINTIGRAPHY STAGING SYSTEM PROSTHESIS SPINAL STABILITY SPINAL CORD DECOMPRESSION ANTERIOR APPROACH TO THE SPINE 骨転移生命予後手術適応人工椎体置換術

项目摘要

1)Diagnostic imaging modalities Bone scintigraphy with ^<99m>Tc phosphate proved to Provide the most sensitive image for early detection of spine metastases as compared to roentgen examination or ^<67>Ga citrate scintigraphy.2)To establish a staging system in metastatic bone disease and to identify the risk factors promoting bone metastasis. Disease progress could be assessed with advancement in the stage: stage 1 bone metastasis in the central skeletal system (Th.L.and Ribs). stage 2 bone metastasis in the central and intermediate skeletal system(Central + Pelvis,Skull). stage 3 bone metastasis in the central, intermediate and peripheral skeletal system. Osteolytic nature of metastatic lesion and enhanced tumor marker activity often proved to be the risk factor.3)Proposal of surgical management to cancer metastasis of the spine. Ceramic prosthesis was devised to replace the affected vertebra. Procedures to introduce the prosthesis and to anchor it into the spine were developed.4)To test mechanical property of the prosthesis and mechanical strength of the vertebra-prosthesis-vertebra complex. The prosthesis anchored screws and bone cement provided a sufficient strength to bear body weight.5)Indication, contraindication of the surgery, postoperaive managements and supportive cares for patients were established.6)Postoperative radiotherapy onto the affected level of the spine proved to be the most effective measure for preventing local recurrence and sustaining surgical improvement.

1)影像学诊断<99m>方法：与X线检查或~（13）Ga柠檬酸盐骨显像相比，~（13）Tc磷酸盐骨显像对脊柱转移瘤的早期诊断最为敏感<67>。2）建立转移性骨疾病的分期系统，明确骨转移的危险因素。疾病进展可以用阶段的进展来评估：中央骨骼系统（Th.L.和肋骨）中的1期骨转移。中央和中间骨骼系统（中央+骨盆，颅骨）中的2期骨转移。在中央、中间和外周骨骼系统中的3期骨转移。转移灶的溶骨性和肿瘤标志物的活性增强往往被证明是危险因素。3）脊柱转移癌的外科治疗建议。陶瓷假体被设计来替换受影响的椎骨。4）测试假体的力学性能和椎体-假体-椎体复合体的力学强度。5）明确了手术适应证、禁忌证、术后处理和支持护理; 6）术后对患侧脊柱进行放射治疗是预防局部复发和维持手术效果的最有效措施。