椎管内硬膜下肿瘤的手术治疗

Surgical treatment of intradural tumor

[目的]探讨颈椎管内硬膜下肿瘤的手术治疗方法及疗效。[方法]回顾性分析经手术治疗的21例颈椎管内硬膜下肿瘤患者的临床资料及治疗效果,所有病人均行颈椎后路椎板切除椎管减压进行肿瘤切除,部分病人并行后路钉棒系统内固定。[结果]15例完全切除,4例次全切除,2例部分切除;症状消失13例,症状减轻7例,症状恶化1例,无死亡病例发生。[结论]术前根据影像学资料仔细评价肿瘤大小及肿瘤与脊髓的关系是决定手术成功的关键,术中仔细操作避免损伤脊髓,并注意保护好椎动脉及防止椎管内静脉丛大出血,是将肿瘤完全切除的前提。

[ Objective ] To investigate results of surgical treatment of intradural tumors of the cervical spinal cord. [ Method] Twenty-one cases with cervical intradural tumor were treated surgically under posterior approach from 1999 to 2005, all patients were performed cervical laminae resection before tumor resection, and some received internal fixation. All patients were followed up for 8 months to 38 months respectively. All the clinical materials were analyzed retrospectively. [ Result] All patients survived the operation, symptoms disappeared 13, relieved 7 and deteriorated 1. Total resection in 15 cases, subtotal 4 cases and partial 2 cases. [ Conclusion] To succeed the operation, it is very important to make clear the location and size of the tumor and the relationship between the tumor and spinal cord; in order to gain total resection of tumor, both careful protection of spinal cord and vertebral artery and intraspinal cannal veins are essence.