上颈椎椎管内外哑铃形肿瘤的临床特点及外科治疗

Clinical characteristics and surgical intervention of upper cervical dumbbell-shaped intra-extradural tumors

目的探讨上颈椎椎管内外哑铃形肿瘤的临床特点及外科治疗方法。方法回顾性分析本院1999年1月。2007年5月收治的33例上颈椎椎管内外哑铃形肿瘤患者，经颈后外侧入路行肿瘤切除26例，前后联合入路行肿瘤切除7例；20例采用后路钉棒／钉板内固定系统重建，13例未行内固定。结果术后随访6个月～8年，平均18．3个月。多数患者症状改善明显，4例复发，其中2例再次手术。结论上颈椎椎管内外哑铃形肿瘤临床相对少见，手术风险较大。根据肿瘤部位、性质和分期制定合理的手术方案能提高肿瘤切除率，降低术后局部复发率和并发症的发生率。

Objective To investigate the clinical characteristics and surgical intervention of upper cervical dumbbellshaped intra-extradural tumors. Methods A retrospective review was made on 33. cases of upper cervical dumbbell-shaped intra-extradural tumors from Jan. 1999 to May. 2007. Resections were performed on 26 patients through posterior-lateral approach, 7 patients through anterior-lateral combined with posterior-lateral approach. Posterior lateral mass screw internal fixation system were u＇sed in 20 cases, none fixation in 13 cases. Results All the cases were followed up for 6 - 96 months with an average time of 18.3 months. The effects after operation were satisfactory in majority cases. Local recurrence was occurred in 4 cases and 2 of them received reoperation. Conclusion Upper cervical dumbbell-shaped intra-extradural tumors are rarely seen and the risk of operation is high. The surgical approach and operative methods must be selected according to the location, surgical staging, and characteristics of tumors in order to increase the tumor resection rate and to decrease the local recurrence rate and the incidence rate of complications.