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已发表论文
对于伴有神经功能损害的胸腰椎转移性肿瘤采用减压、椎体成形术和放疗三联疗法的临床疗效及安全性
Authors Wang JM, Liu PS, Zou DX, Zhang JF, Sun T, Jiang JJ, Liu JQ, Du W
Received 10 June 2025
Accepted for publication 20 September 2025
Published 17 October 2025 Volume 2025:18 Pages 6783—6793
DOI https://doi.org/10.2147/JMDH.S542409
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Charles V Pollack
Jian-Min Wang,1,2,* Pei-Sheng Liu,1,2,* De-Xin Zou,1,2 Jian-Feng Zhang,1,2 Tao Sun,2 Jun-Jie Jiang,2 Jian-Qing Liu,1,2 Wei Du1,2
1Department of Spine Surgery, Yantaishan Hospital Affiliated to Binzhou Medical University, Yantai, Shandong, 264003, People’s Republic of China; 2Yantai Key Laboratory of Repair and Reconstruction of Bone & Joint, Yantaishan Hospital Affiliated to Binzhou Medical University, Yantai, Shandong, 264003, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Wei Du, Department of Spine Surgery, Yantaishan Hospital Affiliated to Binzhou Medical University, No. 10087, Keji Avenue, Laishan District, Yantai, 264003, People’s Republic of China, Tel +86 0535 6863895, Fax +86 0535 6863937, Email duwei121282@163.com
Objective: To evaluate the clinical efficacy and safety of a triple-modality therapy—decompression, vertebral augmentation, and radiotherapy—in patients with thoracolumbar metastatic tumors accompanied by neurological injury.
Methods: A retrospective analysis was performed involving 86 patients who underwent treatment for thoracolumbar metastatic tumors with neurological involvement between January 2017 and December 2022. Participants were categorized into two groups: a control group (n = 45) that received conventional separation surgery combined with pedicle screw fixation, and an intervention group (n = 41) that received the triple-modality therapy. This therapeutic approach comprised (1) decompression through separation surgery, which involved excision of tumor tissue adjacent to the dura mater to establish a protective margin; (2) vertebral augmentation via bone cement injection into the affected vertebrae, along with bone cement-augmented pedicle screw fixation; and (3) stereotactic radiosurgery. Postoperative outcomes, including pain intensity, neurological function, and quality of life, were assessed and compared between groups.
Results: The intervention group experienced significantly longer surgical durations but demonstrated reduced intraoperative blood loss compared with the control group (p < 0.05). Both groups demonstrated improvements in pain levels, neurological function, and quality of life following surgery. However, the intervention group exhibited significantly lower visual analogue scale scores at the final follow-up (p < 0.05). Additionally, significant improvements were observed in the Frankel grade and Karnofsky Performance Status scores within the intervention group compared with the control group at the final follow-up (both p < 0.05). The Cobb angle in the control group demonstrated a significant increase from 1 week postoperatively to the final follow-up (p < 0.05).
Conclusion: The decompression-vertebral augmentation-radiotherapy triple-modality therapy demonstrated efficacy in alleviating pain, promoting neurological recovery, and improving quality of life while maintaining spinal stability and a low rate of complications.
Keywords: neurological injury, separation surgery, stereotactic radiosurgery, thoracolumbar metastatic tumors, vertebral augmentation
1Department of Spine Surgery, Yantaishan Hospital Affiliated to Binzhou Medical University, Yantai, Shandong, 264003, People’s Republic of China; 2Yantai Key Laboratory of Repair and Reconstruction of Bone & Joint, Yantaishan Hospital Affiliated to Binzhou Medical University, Yantai, Shandong, 264003, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Wei Du, Department of Spine Surgery, Yantaishan Hospital Affiliated to Binzhou Medical University, No. 10087, Keji Avenue, Laishan District, Yantai, 264003, People’s Republic of China, Tel +86 0535 6863895, Fax +86 0535 6863937, Email duwei121282@163.com
Objective: To evaluate the clinical efficacy and safety of a triple-modality therapy—decompression, vertebral augmentation, and radiotherapy—in patients with thoracolumbar metastatic tumors accompanied by neurological injury.
Methods: A retrospective analysis was performed involving 86 patients who underwent treatment for thoracolumbar metastatic tumors with neurological involvement between January 2017 and December 2022. Participants were categorized into two groups: a control group (n = 45) that received conventional separation surgery combined with pedicle screw fixation, and an intervention group (n = 41) that received the triple-modality therapy. This therapeutic approach comprised (1) decompression through separation surgery, which involved excision of tumor tissue adjacent to the dura mater to establish a protective margin; (2) vertebral augmentation via bone cement injection into the affected vertebrae, along with bone cement-augmented pedicle screw fixation; and (3) stereotactic radiosurgery. Postoperative outcomes, including pain intensity, neurological function, and quality of life, were assessed and compared between groups.
Results: The intervention group experienced significantly longer surgical durations but demonstrated reduced intraoperative blood loss compared with the control group (p < 0.05). Both groups demonstrated improvements in pain levels, neurological function, and quality of life following surgery. However, the intervention group exhibited significantly lower visual analogue scale scores at the final follow-up (p < 0.05). Additionally, significant improvements were observed in the Frankel grade and Karnofsky Performance Status scores within the intervention group compared with the control group at the final follow-up (both p < 0.05). The Cobb angle in the control group demonstrated a significant increase from 1 week postoperatively to the final follow-up (p < 0.05).
Conclusion: The decompression-vertebral augmentation-radiotherapy triple-modality therapy demonstrated efficacy in alleviating pain, promoting neurological recovery, and improving quality of life while maintaining spinal stability and a low rate of complications.
Keywords: neurological injury, separation surgery, stereotactic radiosurgery, thoracolumbar metastatic tumors, vertebral augmentation