枕骨大孔区肿瘤的显微外科治疗

Microsurgery for Tumours in Foramen Magnum

目的探讨枕骨大孔区肿瘤的诊断和治疗方法。方法我院1992年3月至2008年4月收治22例枕骨大孔区肿瘤患者,全部采用显微外科手术切除;其中经枕下正中入路手术切除20例,经外侧枕下枕骨髁入路手术切除2例。结果肿瘤全切除18例,次全切除3例,部分切除1例。无手术死亡。术后15例随访4个月至8年,12例恢复正常工作和生活;2例肢体肌力有改善,但肌萎缩无好转;1例四肢轻瘫,可扶行。术后病理诊断:神经鞘瘤13例,脑(脊)膜瘤5例,血管网织细胞瘤4例。结论枕骨大孔区肿瘤起病隐匿,早期常易被误诊。MRI对诊断有决定性意义。采用显微外科手术切除肿瘤,绝大多数患者可得到根治。

Objective To explore the diagnosis and microsurgical treatment of the tumors in the foramen magnum. Methods The clinical data of 22 patients with tumors in the foramea magnum who underwent microsurgery in our hospital from March, 1992 to April, 2008 were analyzed retrospectively. Microsurgery through suboceipital approach and lateral transeondylar approach was performed respectively in 20 patients and in 2 patients. Results The tumors were totally resected in 18 patients, subtotally in 3 and partially in 1. No patients died of surgery. Of 15 patients followed up from 4 months to 8 years, 12 were recovered well, 2 improved in the muscle power of the limbs and 1 had slight palsy of his four limbs. Conclusions The symptoms of tumors in the foramen magnum are occult early, and they are often misdiagnosed. MRI is a essential method to diagnose the tumors in the foramen magnum. The curative effects of mierosurgery on the patients with tumors in foramen magnum arc good.