腰椎管硬膜内肿瘤的诊断与手术治疗

Diagnosis and surgical treatment of intradural tumors in lumbar spinal cord (canal)

目的探讨腰椎管硬膜内肿瘤的诊断及治疗要点。方法回顾性分析1999年10月～2006年10月25例腰椎管硬膜内肿瘤患者的临床表现和诊断及手术治疗。结果25例为良性肿瘤，23例完整切除，2例大部分切除。随访时间1-8年，术后25例症状明显改善，神经功能恢复满意；6例会阴部和下肢轻度麻木。结论腰椎管硬膜内肿瘤早期易漏诊误诊，早期诊断要详细询问病史、认真查体结合影像学检查；MRI所见为诊断主要依据，可作为首选。肿瘤完整切除率高，诊断一旦确立，应尽早手术，神经功能恢复良好。

Objective To evaluate the diagnosis and main surgical procedure for the intradural tumors of lumbar spinal canal. Methods Clinical symptoms, diagnosis and surgical treatment of 25 patients with benign tumors of intra lumber spinal canal from October 1997 to October 2006 were reviewed and analyzed retrospectively. Results The tumors in 23 cases were excised completely and mostly for 2 patients. All of them were followed up for 1 - 8 years. After operation, the clinical symptoms were relieved remarkably and the nerve functions recovered satisfaetorily in all cases, gentle numbness remained on perineum and lower extremity in 6 cases . Conclusion In the early stage of the intradural tumors of lumbar spinal canal, it is frequent to miss a diagnosis or make a erroneous diagnosis. Detailed history inquiry and physical examination combining with necessary image examination, especially MR] findings, are very important to make an early correct diagnosis. After the diagnosis is established, early surgery is recommended for the nerve function recovering.