颈部哑铃形肿物的显微外科治疗

Microsurgical Treatment of Dumbbell Tumors of Cervical Spine

目的 探讨颈部哑铃形肿瘤常用手术方法及手术入路。方法 大多数肿瘤经后正中入路椎板或部分椎板切除及单侧小关节切除进行手术,部分病例经颈前外侧及后正中联合入路手术。术中切除肿瘤在显微镜下进行。结果 所有病例术后MRI检查示肿瘤全切,1例脊膜瘤术后半年复发,再次手术后痊愈。术后大多数病例症状明显改善,无加重及死亡病例。结论 采用合适的手术入路,精细的显微外科操作,可提高疗效、减少术后并发症的发生。

Objective To study the surgical methods and evaluate the operative approaches to the dumbbell tumors of cervical spine. Methods Most of these tumors were removed via posterior midline approach with complete or partial laminectomy and unilateral facetectomy. In some of the tumors the combined anterior-lateral to the cervical spine and posterior midline approach was performed. All these operative procedures were completed under the surgical microscope. Results Complete tumors resection confirmed by MRI was achieved in all the patients. There was no perioperative mortality. There was recurrence of the tumor in one case 6 months after the operation and this patient was cured after the second surgery. The symptoms were remarkably improved postoperatively in most cases. Conclusion The appropriate surgical approach and meticulous microsurgical manipulation are the key to reducing postoperative complications and improving the curative effect in the patients with dumbbell tumors of the cervical spines.