Саратовский научно-медицинский ЖУРНАЛ

Сравнительный анализ результатов хирургического лечения метастатических поражений грудного отдела позвоночника (систематический обзор)

Резюме:

Цель: провести сравнительный анализ эффективности хирургического лечения пациентов с метастатическими поражениями грудного отдела позвоночника из переднего и заднего доступов по данным литературы. Методика написания обзора. Поиск осуществлен в базах данных PubMed и Scopus. Поисковые слова и словосочетания: "thoracic spine", "metastatic lesion", "spinal cord", "management of thoracic spine metastasis". Глубина поиска — последние 15 лет. В итоговый анализ включено 13 публикаций. Заключение. Оба подхода являются эффективными, однако такие показатели, как кровопотеря, продолжительность вмешательства, неврологическая динамика и интенсивность боли, значительно лучше у пациентов, которым проводили передние вмешательства. В то же время в группе передних вмешательств чаще наблюдается развитие дыхательной недостаточности, и уровень 30-дневной летальности выше по сравнению с группой задних доступов. При этом в группе задних вмешательств достоверно отмечается более высокий уровень послеоперационной ликвореи и раневой инфекции, а также усугубление неврологических нарушений. Частота несостоятельности имплантированных конструкций и ревизионных вмешательств по поводу гематом операционной раны и рецидивирующего роста опухоли практически одинаковая.

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