显微手术治疗颈胸腰段椎管内硬膜外蛛网膜囊肿

Microsurgical treatment for cervical, thoracic and lumbar spinal extradural arachnoid cysts

目的探讨颈胸腰段椎管内硬膜外蛛网膜囊肿的临床特点和治疗方法。方法回顾性分析2011年1月至2013年11月收治的有明确症状的15例颈胸腰椎管内硬膜外蛛网膜囊肿患者。其中，1例发生于颈段，12例发生于胸腰段，2例发生于腰段。症状以腰腿疼痛为主，部分患者存在间歇性跛行和感觉功能障碍。结果15例均行显微手术切除囊肿，术中探查并找到囊肿和硬脊膜囊交通孔予以封闭。术后早期患者症状改善明显。随访1～32个月，平均19个月，均未见囊肿复发。其中，11例症状消失，4例症状缓解，不影响正常生活。结论对有明确症状的椎管内硬膜外蛛网膜囊肿患者，应首选显微手术治疗。手术方法采用囊肿切除、交通孔封闭、椎板复位，临床疗效良好。

Objective To explore the clinical features and surgical treatment of cervical, thoracic and lumbar spinal extradural araehnoid cysts. Methods The clinical data of 15 patients with cervical, thoracic and lumbarspinal extradural arachnoid cysts in our department from Jan 2011 to Nov 2013 were analyzed respectively. Of 15 patients, 1 case occurred in cervical segment, 12 in thoracolumbar segment, and 2 in lumbar segrnenL The symptom was given priority to the pain of lumbosaeral region, followed by intermittent claudication and sensory dysfunction. Results 15 patients were treated by microsurgical operation to remove the cysts, explore and close the access hole between the cyst and dural sac. In early postoperative period, the symptoms were relieved significantly. 15 patients were followed -up from 1 to 32 months （mean duration： 19 months） and there was no cyst recurrence. The symptoms of 11 patients were disappeared, and 4 with relief of symptoms and without influence on their daily life. Conclusions Microsurgery was recommended for the patients with spinal extradural araehnoid cysts who suffered from significant symptoms, which included the cyst resection, access hole closure and lamina replacement. Excellent or good clinical effect could be achieved.