颈髓肿瘤的显微外科治疗

Microsurgical treatment of cervical spinal cord tumors

目的探讨颈髓肿瘤的显微外科治疗方法。方法根据肿瘤的不同部位和病理类型，对36例肿瘤（髓内12例，髓外24例）选择不同的手术入路和方法。结果髓内肿瘤12例中10例获得全切，7例术后神经功能明显改善或稳定。髓外肿瘤24例中22例获得全切，23例术后神经功能明显改善或稳定。结论颈髓肿瘤应采用显微外科技术治疗，能有效的保护脊髓组织及神经，减少神经功能障碍的进一步加重，提高手术全切率，改善预后。手术入路的选择应根据肿瘤的部位、大小、发展方向和病理类型选择不同的手术入路。

Objective To explore the microsurgical methods for patients with cervical spinal cord tumors. Methods According to different sites and histopathological types, 36 patients （intramedullary tumors： 12, extramedullary tumors： 24） were surgically treated with different approaches and methods. Results Tumors were totally removed in 10 of 12 patients with intramedullary tumors （83.3%） and 22 of 24 patients with extramedullary tumor （91.7%）. Seven of 12 patients with intramedullary tumors （58.3%） and 23 of 24 patients with extramedullary tumors （95.8%） got improvement or kept stable in the neurological status. Conclusions Microsurgical technique, protecting the spinal cord and nerves effectively and avoiding the neurological disturbance, can be employed in the treatment of patients with cervical spinal cord tumors with high total removal rate and good prognosis. Surgical approaches should be chosen according to the location, size, extension and histopathological classifications of the tumors.