多节段椎管内肿瘤的外科治疗

Surgical treatment for multisegmental intraspinal tumors of the spine

目的探讨多节段椎管内肿瘤的特点、诊断、手术方法及临床效果。方法 15例多节段椎管内肿瘤患者行MRI检查示肿瘤组织压迫脊髓。均行后路常规手术入路切除肿瘤,行钉棒系统内固定。结果 15例均获得随访,时间12～50个月。术后影像学检查植骨融合良好。术后6个月按Frankel分级:C级2例恢复至D级1例、E级1例,D级13例恢复至E级10例,3例无恢复。结论经后路全椎板切除肿瘤治疗多节段椎管内肿瘤,患者术后症状大多数可以明显改善。多节段椎板切开术后应给予脊柱内固定,以保持脊柱的稳定性。

Objective To investigate the character,diagnosis,surgical procedure and clinical effect of multisegmental intraspinal tumors.Methods 15 patients with multisegmental intraspinal tumor of the spine were treated.Spinal cord was pressed by tissue of tumor in fifteen patients shown on magnetic resonance imaging（MRI）.They were treated by posterior approach for removal of the tumors after laminectomy,and fixation with pedicle screw rod system.Results The follow up was obtained for 12～50 months.The good fusion of bone graft was found in iconography examination.Six months after operation,according to the Frankel grading system,10 cases recovered from D to E,3 cases of D hadn′t changed,1 case recovered from C to D,1 case recovered from C to E.Conclusions With the treatment by posterior approach to remove of multisegmental intraspinal tumors after laminectomy,most of the symptoms can be released after surgical treatment.After multisemental laminotomy the vertebral plate should be repositioned or the spine should be internal fixed to ensure the stability of the spinal column.