显微手术切除及椎管固定融合治疗高颈段椎管哑铃型肿瘤

Microsurgery Treatment and Cervical Vertebral Fusion for Upper Cervical Dumbbell Tumor

目的探讨显微手术切除高颈段椎管哑铃型肿瘤及椎管固定融合的方法及效果。方法回顾性分析11例高颈段椎管哑铃型肿瘤患者的临床资料,其中ToyamaⅡ型6例,Ⅲ型4例,Ⅴ型1例。均行显微手术切除,其中远外侧入路3例,颈后正中入路8例。同时行椎管固定融合6例。结果本组全切10例,次全切除1例。术后病理学诊断为神经纤维瘤9例,脊膜瘤2例。术后症状明显改善9例,改善2例,无感染及死亡病例。随访10例,平均时间27个月(3个月～3年),患者的症状和神经功能均有不同程度的改善,无颈椎不稳及后凸畸形。结论高颈段椎管哑铃型肿瘤显微手术切除并椎管固定融合能明显改善症状,安全性好,并发症少。

Objective To study the method and effect on microsurgical treatment and spinal fusion of upper cervical vertebral canal dumbbell tumors.Methods The clinical data of 11 cases suffered upper cervical dumbbell tumor was analyzed retrospectively,including 6 cases of type Ⅱ,4 cases of type Ⅲ and 1 case of type Ⅴ according to Toyama typing.All 11 cases were performed microsurgery via far lateral approach in 3 cases and cervical posterior midline approach in 8 cases.Among them,6 cases received spinal fusion.Results 10 cases were performed total resection and 1 case were performed subtotal resection.The post operative pathology exam revealed neurofibroma in 9 cases and spinal meningioma in 2 cases.The symptoms were improved in all cases without infection and death after operation.10 cases were followed up for 3 months to 3 years（average 27 months）.All symptoms and nerve function were improved without cervical vertebral instability and cervical kyphosis.Conclusion Microsurgical resection and spinal fusion can improve the symptoms obviously for dumbbell tumor in upper cervical spinal cord with better security and fewer complications.