脊椎管内神经鞘瘤的手术治疗(附25例报告)

Operative Treatment of Schwannoma in the Spinal Canal(A Report of 25 wases)

目的：回顾性临床研究25例脊椎管内神经鞘瘤及手术治疗结果。方法：分别描述颈段（12例）、胸段（4例）和腰段（9例）肿瘤的临床表现和类型，以及影像学检查结果，包括X线平片、脊髓造影、CT和MRI。19例肿瘤全部切除，6例大部切除。优良率为80％，3例术后复发再次治疗，4例发生并发症，结论：①详细描述了肿③部位、侵犯范围、形态学特征及病理变化，对肿瘤的诊断治疗很有意义。②应遵循临床检查、影像学检查、手术探查和病理识别及切片检查相结合的诊断程序。③术前充分估计手术困难程度、术中全部切除肿瘤并保护神经组织、以提高治疗效果。

Objcct: Twenty-five patients with Schwannoma in the spinal canal and their surgical results were retrospectively and clinically studied. Methods: The clinical manifestation and types, results of spinal plain radiopaphy. myelography, CT scanning, and MRimaging of cervical tumors in 12 cascs,thoracic tumors in 4, and lambar tumors in 9 were separately deseribed. All of the 25 patients were surgically treated, the tumors of 19 patients were complctely resected and 6 were subtotally excised. Results:Excellent and good results were obtained in 80% of the poticnts, reoperation was performed for tumor recurrence in 3, and complication occured in 4. Concluson: (1) pathological changes such as tumor location,cxtent, morphological teatures were described in detail, which is significant for diagnosis and treatment.(2)A diagnostic procedure combining with clinical and imaging examinations. operative exploration and pathological recognition, and microscopic examination should be obtained. (3)For improving surgical results,difficu1t extent of operation should be prooperytively estimated, the tumor is totally excised and nerve tissue is sateguarded on operation.