颈胸段脊柱原发恶性肿瘤的手术治疗现状及进展

李冬月; 刘晓光; 刘忠军

doi:10.3969/j.issn.2095-252X.2015.08.015

摘要：Cervicothoracic spine is a special position in the anatomy andbiomechanics. The anterior includes a variety of tissues, organs and nerves. And the lesion gets deeper owing to the chest. In addition, the concentrated spinal stress makes a high risk of failure of the internal fixation. So, surgical treatment is of great difficulty for primary malignant tumors at the cervicothoracic junction. There are many disputes in the surgical approach for the cervicothoracic tumors. The proximal C7-T1 lesions can obtain a clear exposure by an anterior low suprasternal approach alone. On the contrary, access to the distal T2-4 lesions through an anterior approach is generally considered to be dififcult and need to becombined with sternotomy or thoracotomy. But the single posterior total spondylectomy can avoid large injury and severe complications caused by the anterior approach. Total spondylectomy can make spinal tumors reach the wide or marginal excision. In recent years, total spondylectomy is being widely used in the treatment of spinal primary malignant tumors, which is helpful to complete removal of the tumor and effective decrease of the local recurrence. Cervicothoracic junction changes from the lordosis and active cervical to kyphosis and relatively ifxed thoracic vertebrae. It is also a signiifcant change for vertebral morphology and spinal stress. For this reason, in the spinal reconstruction, the form and stress of the internal ifxation have a certain speciifcity. This article reviewed the progress of surgical treatment and spinal reconstruction for cervicothoracic primary malignant tumors.