臨床整形外科58巻12号

2023年12月発行

特集 がん時代の整形外科必携！　骨転移診療アップデート 骨転移手術各論

脊椎転移手術のTips ＆ Pitfalls

著者： 古矢丈雄¹ 志賀康浩¹ 白谷悠貴¹ 俊徳保¹ 大山秀平¹ 大鳥精司¹

所属機関： ¹千葉大学医学部附属病院整形外科

ページ範囲：P.1439 - P.1446

がんの骨転移は脊椎に好発する．脊椎転移は病的骨折や脊柱管内への浸潤により局所痛，脊柱の不安定性，神経障害を引き起こす．保存療法抵抗性の疼痛，脊椎不安定性を伴う病態，進行性の神経障害は脊椎手術の適応となる．手術は姑息的手術と根治術に大別され，個々の症例によって術式が検討される．手術の適応，術式選択においては，原発科や関連診療科との連携をとりながら，がん種，腫瘍の局在，不安定性の有無，神経症状，腫瘍学的予後，全身状態，患者の希望などを総合的に判断し，治療計画を立てる．

参考文献

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