椎管内蛛网膜囊肿诊断及手术方式研究

Research of the diagnosis and surgical methods of intraspinal arachnoid cysts

目的探讨椎管内蛛网膜囊肿的诊断要点及手术方式。方法回顾性分析我院2001~2012年收治的9例椎管内蛛网膜囊肿病例,对其影像特点、病理特征、手术治疗进行总结。结果囊肿全切5例,囊肿次全切除加内引流4例。术后7例患者症状改善,2例无明显变化。随访3个月~11年,1例失访,4例复发。结论 MRI对术前诊断很重要。全椎板切除对囊肿暴露更好,半椎板切除脊柱稳定性更高。对粘连严重的囊肿不要求强行做全切除,次全切除并打通囊肿与脑脊液的交通即可。

Objecvtive To investigate the diagnosis and surgical methods of intraspinal arachnoid cysts. Methods The clinical data of 9 patients with intraspinal arachnoid cysts treated in our hospital from 2001 and 2012 were analyzed retrospectively,and the characteristics of image,pathology and surgical treatment were summarized. Results 5 patients received total resection of tumors and 4 subtotal with internal drainage. 7 patients got improvement of symptoms after surgery,2got no significant improvement. One patient missed the follow-up during 3 months to 11 years and 4suffered cyst recurrence. Conclusions MRI is of great importance in diagnosis. Laminectomy is better to expose the cyst while semi-laminectomy is more stable than the former. Severe adhesion cysts do not need forced total removal,subtotal resection and establish commnication between the cyst and the cistern is enough.