硬脊膜内脂肪瘤的诊断与治疗

Diagnosis and treatment of intradural spinal cord lipomas

目的 :探讨硬脊膜内脂肪瘤的诊断和治疗方法。方法 :分析 8例硬脊膜内脂肪瘤患者的临床特点、神经放射学资料。经背正中切口入路用显微外科技术切除肿瘤。结果 :8例中 ,3例予次全切除 ,5例予部分切除。术后症状明显好转 3例 ,部分好转 2例 ,无变化 2例 ,加重 1例。结论 :CT和MRI有助于确诊本病 ,症状明显者应行显微外科减压。

Objective:Report a series of eight patients with intradural spinal cord lipomas.Explore the diagnosis and treatment methods of the lesion.Method:Clinical features and neuroradiological materials of the 8 patients were studied.Microsurgical operation was done on each patient via the posterior median approach.Result:Subtotal,partial removal were achieved in 3 and 5 patients,respectively.Overall,at the time of discharge,3 patients were significantly improved,2 were partially improved,2 unchanged and 1 worsened.Literatures were reviewed,and some questions pertaining to intradural spinal cord lipomas were discussed.Conclusion:CT and MRI are decisive exam tools for intradural spinal cord lipoma diagnosis.Surgical intervention is necessary if symptoms are getting worse progressively.The key points of operation are microsurgical decompression. Author′s address\ Department of Neurosurgery,Changzheng Hospital,Shanghai,200003