腰骶段椎管肿瘤的诊治

Diagnosis and Treatment of Lumbar - Sacral Tumor

研究腰骶段椎管肿瘤的诊断、治疗方法,以防止误诊。方法:回顾性分析我院手术治疗的31例病例。结果:椎管造影和MRI检查明确诊断22例,CT检查诊断9例,其中误诊4例;肿瘤全切22例,大部分或部分切除8例,肿瘤活检1例;术后所有病例自觉症状均有改善,其中腰骶部及下肢疼痛消失或减轻100%,排尿排便改善75%,下肢肌力改善60.9%。结论:详细的病史询问、体格检查及合适的辅助检查可避免误诊的发生;MRI检查是诊断腰骶段椎管肿瘤的首选方法;腰骶段椎管肿瘤以手术治疗为唯一最有效的方法,但对于部分不能全切的病例,适当辅以放、化疗,仍能取得较好效果。

BACKGROUND & OBJECTIVE: To review the diagnostic and treatment methods for lumbar-sacral tumor (LST) with a view to avoid misdiagnosis and to improve treatment of LST. METHODS: Retrospective re-view of 31 cases of LST treated in our hospital. RESULTS: LST cases were diagnosed using myelograph and MRI in 22 cases; all diagnosis was correct. CT scan was the diagnostic test used in 9 cases; however, in four of the cases the diagno-sis was not correct. Tumors were totally removed in 22 cases, and subtotally or partially in 8 cases. In 1 case only biopsy was performed. Symptoms were alleviated in all LST cases. Low back and lower limbs pain were alleviated in all cases.Dysfunction of bladder or bowel were alleviated in 75% of cases. And lower limb weakness was alleviated in 60. 9% of cases. CONCLUSIONS: Detailed history and physical examination were supplemented with appropriate investigations,in which MRI is the first choice and could avoid misdiagnosis of LST. Surgical treatment is the most effective method for LST. In combination with appropriate radiotherapy and chemotherapy for residual tumor, good clinical results can be achieved.