胸段哑铃型椎管肿瘤的诊断与治疗

Diagnosis and treatment of the dumbbell tumor of thoracic spinal canal

目的探讨胸段哑铃形椎管肿瘤的临床诊断与手术治疗经验。方法回顾性分析19例胸段哑铃形椎管肿瘤的资料。结果Ⅰ型胸段哑铃形椎管肿瘤17例,Ⅲ型胸段哑铃形椎管肿瘤2例;胸腔纵隔内肿瘤较大可采用联合入路,椎管外肿瘤较小可采用单纯椎管入路;病理组织学检查多数为良性肿瘤,预后均良好。结论大部分胸段哑铃形椎管肿瘤单纯经后正中椎管入路手术,肿瘤巨大或椎旁肿瘤较大者需选择经胸经椎管联合入路手术。

Objective To explore the clinical diagnosis and surgical experiences of the dumbbell tumors in thoracic spinal canal. Methods The clinical data of 19 patients with the dumbbell tumors of thoracic spinal canal were analyzed retrospectively. Results 17 patients were diagnosed as the type I dumbbell tumors of thoracic spinal canal, while 2 were type m. The mediastinum thoracic tumors were comparatively bigger, which could be applied by combined approach,while the extraspinal tumors were smaller, which could be applied by simple intraspinal approach. Histopathological examination suggested that most tumors were benign along with good prognosis. Conclusions Most of these tumors are removed simply through posterior midline spinal approach, while the operation through combined with thoracic and spinal approach should be performed for huge tumors and paravertebral tumors in an attempt for stage-I surgery.