颈段脊髓侧方及腹侧肿瘤的外科治疗

Surgical Treatment of Tumors Lateral and ventral to Cenical Spinal Cord

目的 对颈段脊髓侧方及腹侧肿瘤的临床分型和手术入路及方法进行探讨。方法 32例,经脊髓造影、CT和MR扫描确诊。根据检查及手术所见进行分类,并进行手术入路比较研究。结果 肿瘤全切28例(87.5％),3例好转,1例(3.1％)死亡。按照肿瘤大小及发展将其分为4类,提出3种手术入路方式。结论 对该部肿瘤进行分类,对每类肿瘤选用相应手术入路有利于全切肿瘤,并强调显微神经外科在切除该部肿瘤时的重要性。

Objective To investigate the operative approaches and surgical techniques for treatment of patients with tumors lateral and ventral to the cervical spinal cord. Methods Diagnoses of 32 patients (male 20, female 12) were established after CT, MR and myelographic examinations. Operative approaches were classified according to the clinical and operative findings. Data of these cases were analyzed retrospectively. Results Of the 32 patients, 28 cases(87.5%)recieved total resection of the tumors, one patient died(3.1%). Based on the size and growth of the tumors, they could be divided into 4 types and the opevative approaches were adopted accordingly. Conclusions Proper operative approaches should be varied with the type of tumors. The proper operative approach was the key to eradicating the tumor completely and the microsurgical techniques were of prime importance in the management of tumors lateral or ventral to the cervical spinal cord.