脊髓转移的难题 - - 对当前管理的审查
Bogdan Florin Iliescu1,2, Daniel Ilie Rotariu1,2, Loredana Mariana Agavriloaei1,2
1Department of Neurosurgery, Grigore T Popa University of Medicine and Pharmacy Iasi, 11 Universitatii St, 700115 Iasi, Romania.
Journal of clinical medicine
|October 29, 2025
概括
最少侵入性脊柱外科手术 (MISS) 为脊柱转移提供了比开放式手术更好的结果,流血量更少,住院时间更短. 混合方法和个性化治疗策略正在推动癌症患者的护理.
科学领域:
- 在瘤学瘤学.
- 神经外科 神经外科
- 整形外科手术 整形外科手术
背景情况:
- 脊髓转移是癌症患者疼痛和残疾的主要原因.
- 传统的治疗方法包括化疗,放射治疗和开放式手术.
- 微创脊柱手术 (MISS) 的进展正在改变治疗范式.
研究的目的:
- 审查和比较MISS与传统的开放脊柱手术转移的最新证据.
- 评估新兴的混合治疗方法和临床决策框架.
- 倡导个性化治疗策略,整合预后工具和瘤基因组学.
主要方法:
- 对当前文献进行叙事综述,比较MISS和开放脊柱手术.
- 对混合方法的证据分析,例如分离手术,然后是立体性放射性手术.
- 对临床决策框架 (NOMS,LMNOP,NESMS) 的评估.
主要成果:
- 与开放式手术相比,MISS显示手术内流血减少,住院时间缩短,感染率较低.
- 对于MISS的功能结果与公开程序等同或优于公开程序.
- 混合方法在特定恶性瘤中显示出局部瘤控制的希望.
结论:
- MISS是脊柱转移的开放手术的有利替代方案,为患者提供了显著的益处.
- 混合疗法和先进的决策框架提高了治疗效率.
- 整合预后工具和瘤基因组学对于个性化脊髓转移管理至关重要.
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