胸椎管内肿瘤的诊治和术后随访研究

The diagnosis' treatment and postoperative follow-up study of thoracic intraspinal tumor

目的总结胸椎管内肿瘤的诊断并评价手术治疗效果。方法回顾性分析青岛大学医学院附属医院2002年1月至2010年12月施行手术治疗的188例胸椎管内肿瘤患者的临床资料,总结胸椎管内肿瘤的治疗及预后情况。结果胸椎管内肿瘤多位于髓外硬膜下,以神经鞘瘤和脊膜瘤最常见。经全切除或次全切除后,近期神经根性疼痛、感觉障碍、运动障碍、括约肌功能障碍明显改善。神经功能ASIA评分及分级均明显提高。结论在MRI影像的基础上,配合适当的显微外科技术,选择合适的手术径路和恰当的手术方式是治疗胸椎管内肿瘤的关键。

Objective To summarize the experiences of diagnosis for thoracic intraspinal tumors and to e- valuate the outcome of their surgical treatment. Methods We retrospectively analyzed a series clinic data of 188 patients with thoracic intraspinal tumors who were treated surgically from January 2002 to December 2010 in the paper, summarized treatment and prognosis of intraspinal tumor of thoracic. Results In this series, thoracic intraspinal tumors were most located in pulp external subdural,74.4% （140/188） ,schwannoma and meningio- ma was the most common. Patients symptom of nerve root pain and sensory disturbance was obviously relieved, The function of movement and sphincter obviously improved after total resection or subtotal resection, ASIA scores and classification of neurological function were significantly improved. Conclusions On the basis of the MRI images and with assistant of proper microsurgical techniques to surgical resection, selecting appropriate sur- gical approach and right operation method is the key to treatment of thoracic intraspinal tumors.