高颈段脊髓肿瘤的诊断和显微手术治疗

Diagnosis and microsurgery treatment of upper cervical spinal cord tumors (report of 23 cases)

目的探讨高颈段脊髓肿瘤的诊断和显微手术治疗的效果。方法回顾性分析2000年6月至2010年4月收治的23例高颈段脊髓肿瘤患者的临床资料。结果肿瘤全切除17例,次全切除2例,部分切除或活检4例。19例患者术后随访8～20个月,17例患者恢复良好,恢复正常工作能力;1例无明显变化;1例病情加重,高位截瘫;其中3例病人出现颈椎后凸畸形。结论高颈段脊髓肿瘤早期诊断存在困难,MRI是最有效的辅助检查;利用显微外科技术能提高肿瘤切除率、减少对脊髓的损伤;半椎板入路对颈椎生理曲度及运动度影响小,手术后不稳定发生率低。

Objective To explore the diagnosis of upper cervical spinal cord tumors （UCSCT） and the curative effect of through microsurgery on them.Method The clinical data of 23 patients with UCSCT,who underwent microsurgery in our hospital from June,2000 to April,2010,were analyzed retrospectively,including the clinical manifestation,imaging examination,curative effect,postoperative complication and so on.Results Of 23 patients with UCSCT,17 underwent total resection of the tumors,2 subtotal and 4 part resection or only biopsy.Of 19 patients followed up from 8 to 20 months,17 were recovered well,1 had unchanged clinical symptoms and 1 had worsened clinical symptoms compared to that before the operation.Conclusions The diagnosis of UCSCT is difficult before the operation.MRI is very helpful to diagnosis of UCSCT.The effects of microsurgery through hemilaminectomy on the cervical,curvature,range of cervical motion and spinal stability are smaller.