Text/Yangcheng Evening News all-media reporter Xue Renzheng
Correspondents Jian Wenyang and Dai Xi'an
Photo/Courtesy of respondents
Thyroid cancer with multiple bone metastases throughout the body, spinal metastases cause severe pain, but also lead to paralysis of both lower limbs lying in bed, the quality of life is extremely poor... Such a heart-wrenching patient often leaves doctors helpless. For a long time, the clinical treatment of patients with advanced tumors such as spinal metastases has been a dilemma.
Recently, Chen Kebing, deputy chief physician of the Department of Spine orthopedics of Zhongshan Sixth Hospital, cooperated with a multidisciplinary team to create a "reinforced iron bone" for the damaged spine, reshape the hardness of the spine, and let the original paralyzed patients recover subsequently and miraculously restore part of their perception.
Patients are paralyzed in the lower extremities and are expected to survive for less than 6 months
"It really hurts my mother, I can't sleep in pain, and my lower limbs are paralyzed." Aunt Wang's son choked up.
When Aunt Wang arrived at the hospital, the spinal metastases developed from thyroid cancer were already very serious, and the sphincter could no longer contract spontaneously. Huge malignant tumors envelop and severely squeeze the spinal cord and nerve roots, while invading the muscles behind the spinal canal, which is also the main cause of paralysis of both lower limbs, and the expected survival time is less than 6 months.
Surgery on giant spinal metastases is extremely risky, the operation time is long, the bleeding is abundant, the spinal nerves are abundant, and the slightest carelessness is irreparable, and the difficulty coefficient is extremely high. Chen Kebing and his team will face great challenges.
▲Intraoperative imaging of patients
Creating a "reinforced iron bone" for the spine
Faced with the urgent demands of patients and their families, Chen Kebing chose to face the difficulties.
After multidisciplinary discussion and full preparation for the surgical period, Chen Kebing's team formulated the surgical plan in detail - joint interventional department to advance spinal metastase arterial embolism to ensure that the tumor bleeding is reduced during the subsequent surgical process, perform 360° circular decompression of L2 vertebral malignant metastases, combine bone cement filling isolation surgery, reshape the hardness of the spine, and create a "reinforced iron bone" for the damaged spine.
▲Chen Kebing and his team perform surgery for patients
In order to avoid excessive bleeding of the tumor during the operation, Chen Kebing first asked the interventional department to perform tumor arterial embolization, and then he performed surgical treatment for Aunt Wang, and the amount of bleeding during the operation and the filling position of the bone cement were very precise.
After the operation, a "miracle" appeared, and the patient recovered gratifyingly
"There is a feeling, the legs have a feeling!" On the first day after the operation, Aunt Wang told the doctor that the symptoms of low back pain had improved significantly, and the muscle strength of both lower limbs had miraculously recovered from the preoperative level 0 to level 2, and the treatment effect surprised her very much.
At the same time, the Department of Spine and Orthopedics actively communicated with the Rehabilitation Medical Center of the hospital, combined with the concept of enhanced recovery after surgery (ERAS), and accurately formulated a postoperative rehabilitation and radiation therapy plan for Aunt Wang. After active treatment, the patient's low back pain symptoms were completely alleviated 7 days after the operation, the wound recovered well, the muscle strength of both lower limbs was restored to level 2-3, and simple dorsal bending and leg extension movements could be performed.
Aunt Wang regained her confidence in life and gained new hope.
▲Aunt Wang recovered well after surgery and was able to perform simple dorsal bending and leg extensions
In the next step, the patient will be transferred to the radiotherapy department for radiation therapy, which will further actively combat tumor progression while stabilizing the effect of treatment.
Spinal metastases are not necessarily the "verdict" of the end stage
Chen Kebing introduced that the incidence of spinal metastases is low, but its type is complex, the onset time is short, the disease develops quickly, the treatment effect is poor, and the prognosis is often poor.
In fact, the "bone cement" that has made great contributions to this operation has been widely used in the treatment of spinal tumor patients, and the cytotoxicity and thermogenesis effect of bone cement act on tumor tissues and peripheral nerves, which can effectively kill tumor cells, inhibit local tumor recurrence and alleviate pain symptoms, and its filling effect and physical properties can be restored to a certain extent and maintain spinal stability. Circular decompression combined with bone cement filling isolation for the treatment of spinal metastases can effectively improve the pain and nerve symptoms of spinal metastase patients, improve the quality of life of patients, and avoid the recurrence of neurological symptoms in the original segment after surgery.
Chen Kebing stressed that the appearance of spinal metastases is not necessarily a "judgment" for the terminal stage of cancer. With the advancement of medicine, spinal metastases can still be actively treated, and can improve the quality of life and prolong the lives of patients. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Liu Xinyu