155例椎管内先天性肿瘤的外科诊疗回顾分析

Role of Surgery in the Diagnosis and Treatment of Congenital Intraspinal Tumors

背景与目的:椎管内先天性肿瘤并不少见,本文总结作者近年收治的病例,分析椎管内先天性肿瘤的诊疗。方法:回顾性分析2005年1月至2009年4月经手术和病理明确诊断的155例椎管内先天性肿瘤的病理分型、部位、临床表现、影像学特点。结果:所有患者均接受显微外科手术切除肿瘤。50例全切肿瘤,39例次全切除,47例大部切除,19例部分切除。无术后死亡病例。结论:畸胎瘤、表皮样囊肿、皮样囊肿、肠源性囊肿、脊索瘤和脂肪瘤为常见的良性椎管内先天性肿瘤,由于肿瘤与周围神经组织的粘连紧密,难以全切除。手术首先应保证神经组织的安全,在切除肿瘤过程中,电生理监测可以起到重要的作用。

BACKGROUND & OBJECTIVE: Congenital intraspinal tumors are not rare.In this study,we analyzed diagnosis and treatment of congenital intraspinal tumors.METHODS: From January 2005 to April 2009,155 patients with pathologically confirmed congenital intraspinal tumors were treated in Beijing Tiantan Hospital.Clinical data including pathological types,location,clinical symptoms and signs,and imaging examination were retrospectively analyzed.RESULTS: All the patients received microneurosurgy.Teratomas,dermoid and epidermoid cysts,enterogenous cysts,chordoma and lipomas are common benign intraspinal congenital tumors.Because of adhesion to spinal cord and nerve,total removal of tumor is difficult.Total removal of tumor was achieved in 50 cases,subtotal removal in 39 cases,partial removal in 66 cases.No mortality was observed.CONCLUSION: Surgery plays an important role in the diagnosis and treatment of congenital intraspinal tumors.In operation,preservation of nerve tissue is critical.