椎管内先天性肿瘤的诊断与治疗

Diagnosis and treatment of intraspinal congenital tumors

目的分析椎管内先天性肿瘤的临床特点、诊断及治疗方法。方法回顾分析了2002年1月至2006年4月间在我院手术治疗的68例椎管内先天性肿瘤患者的临床资料,所有患者均行显微手术治疗,随访54例。结果肿瘤全切18例,大部分切除40例,部分切除10例。表皮样囊肿22例,脂肪瘤20例,畸胎瘤14例,皮样囊肿8例,肠源性囊肿4例。随访2～6年,平均4.3年,症状明显改善42例,没有变化10例,恶化2例,无患者死亡。结论先天性肿瘤多为良性病变,好发于青少年。术前MRI及CT分析和显微手术是治疗的关键。

Objective To investigate clinical characteristics,diagnosis and microsurgical treatment of intraspinal congenital tumors.Methods A total of 68 patients with intraspinal congenital tumors who were performed surgery from January 2002 to April 2006 were analyzed retrospectively.All patients received the microsurgical treatment and 54 patients were followed up.Results Gross total removal of tumors was achieved in 18 cases,subtotal removal in 40 cases,and partial removal in 10 cases.There were 22 cases of epidermoid cyst,20 cases of lipoma,14 cases of teratoma,8 cases of dermoid cyst and 4 cases of enterogenous cyst.Post-operative neurological symptoms were improved in 42 patients,remained unchanged in 10 cases,and deterioated in 2 cases during follow-up of 2~6 years（average,4.3 years）.No dead case occurred.Conclusion The most congenital intraspinal cannal tumors are the benign ones.Pre-operative MRI and CT and microsurgical treatment play a key role in the treatment of tumors.