脊髓血管母细胞瘤的微创手术治疗

Minimally invasive surgery of the spinal cord hemangioblastoma

目的探讨脊髓血管母细胞瘤的诊断和微创外科手术治疗方法。方法回顾性分析16例脊髓血管母细胞瘤的病人,对其影像学特点,微创外科治疗的方法进行总结。12例病人行术前MRI检查,9例病人行脊髓血管造影,其中6例行术前栓塞。全部病人行微创外科手术治疗。结果单纯手术10例,其中3例由于术中出血汹涌而部分切除。手术+栓塞6例,病变全切。术后11例症状明显改善,4例无明显变化,1例恶化。结论MRI和脊髓血管造影对该病的诊断和手术方案的制定是必需的。早期诊断和微创外科手术全切能够极大地保护脊髓功能,微创外科手术联合术前栓塞是治疗的首选。

Objective To clarify and discuss the diagnosis and minimally invasive surgery of spinal cord hemangioblastoma. Methods The clinical data of 16 patients with spinal cord hemangioblastoma who were operated on between 1992 and 2001 were analyzed retrospectively with a review of the literature. Results Twelve patients were subjected to MRI examination, nine to spinal cord angiography, and six to preoperative embolization. Thirteen patients underwent complete excision, and three underwent partial excision due to massive bleeding and anterior location of the tumor in spinal cord. Eleven patients showed improvement of their symptoms, four no change at all, and tumor recurrence was seen in one patient with aggravation. Conclusion MRI and spinal angiography are essential for preoperative diagnosis and surgical planning. Early diagnosis and microsurgical resection greatly preserve the neurological function of the patients. Preoperative embolization sometimes is helpful in surgery.