显微手术治疗椎管内肠源性囊肿

The surgical management of intraspinal enterogenous cysts

目的探讨椎管内肠源性囊肿的诊断、影像学检查和显微外科手术治疗的效果。方法回顾性分析2009年4月至2012年8月诊治的18例椎管内肠源性囊肿患者的临床表现、影像学特点、手术方法和治疗效果。结果18例患者术前常规行MRI检查，术前确诊16例；2例术中高度怀疑。18例患者中显微镜下全切囊肿17例，1例大部切除，2例术中切除囊肿后行椎体固定融合术，术后患者均恢复良好。结论椎管内肠源性囊肿具有典型的临床表现和磁共振特点。显微外科技术下手术切除囊壁是椎管内肠源性囊肿最有效且有望治愈的手段。对于肿瘤侵犯椎体、椎弓根或受累椎间关节超过2个节段以上的病例，在全切除病变后，应行相应椎体固定手术，以维持脊柱稳定性。

Objective To study the diagnosis , image investigation and the effection of microsurgical treatment of intraspinal enterogenous cyst. Methods We retrospectively analyzed clinical manifestations ,characteristics of imaging, operative approach and treatment effect of 18 cases which were confirmed for intraspinal enterogenous cyst. Results MRI was done in 18 cases preoperative patients as the routine examination. Among 18 cases, 16 cases could be confirmed preoperatively; highly suspected in 2 cases. Complete resection under the microscope is 17 cases, and vertebral fusion surgery was also done in 2 cases, and all of cases recovered well. Conclusions The clinical manifestations and characteristics of imaging of enterogenous cyst were typical. Microsurgical technique is proper surgical approach which is crucial to total remove and heal intraspinal enterogenous cysts. Tumor invasion of the vertebral body, pedicle or affected intervertebral joint cases more than two segments, after subtotal lesions, corresponding vertebral fixation should be performed in order to maintain the stability of the spine.