颈段椎管内肿瘤的诊断与显微手术

Diagnosis and Microsurgical Treatment of Cervical Intraspinal Canal Tumors

目的探讨颈段椎管内肿瘤的诊断和显微外科技术。方法回顾性分析我院1998年3月至2006年3月间收治的经手术和病理证实的38例颈段椎管内肿瘤患者的临床资料。结果病理诊断为神经鞘膜瘤16例,神经纤维瘤5例,脊膜瘤7例,室管膜瘤4例,胶质瘤2例,血管网状细胞瘤、转移瘤、脂肪瘤、肠源性囊肿各1例。除2例哑铃形神经鞘瘤因椎管外部分体积巨大采取分期手术外,其余病例均一期切除肿瘤,全切率89.5%(34/38),次全或大部切除10.5%(4/38)。结论MRI可提供较全面的颈段椎管内肿瘤诊断信息,是其最佳的诊断方法;显微外科技术可提高肿瘤全切除率,减少手术并发症。

Objectives To explore diagnosis and microsurgical treatment of cervical intraspinal canal tumors. Method The clinical data of 38 patients with cervical intraspinal canal tumors,who were treated by microsurgery in our department from March,1998 to March,2006,were analyzed respectively. All the tumors were proved retrospectively by surgery and pathological examination. Results Thirty-six of 38 cases of tumors were removed in one stage operation except 2 cases of which were removed tumors in two stage operations due to the large extraspinal tumors. Of 38 cases of the tumors,34 were totally removed （89.5%,34/38）,and 4 subtotally or partly （10.5%,4/38）. Pathological examination showed that 16 cases were neurinomas,5 neurofibromas,7 spinal meningiomas,4 ependymocytomas,2 gliomas,1 angioretiuloma,1 metastatic tumor,1 lipoma,and 1 enterogenous cyst. Conclusions MRI of cervical spinal column can provide important information for the diagnosis of cervical intraspinal canal tumor. Microsurgical technique can increase the rate of total removal of the tumor,and decrease operative complications.