椎管内脊膜瘤显微手术切除

Microsurgery for intra-spinal meningioma

目的探讨椎管内脊膜瘤的显微外科手术治疗经验与技巧,以提高其临床疗效。方法回顾性分析38例椎管内脊膜瘤病人的临床表现、影像学资料及随访情况,均行显微外科手术切除肿瘤。结果术后病理检查均确诊为脊膜瘤。按Simpson切除分级:Ⅰ级32例,Ⅱ级5例,Ⅰ、Ⅱ级切除均为全切除,共37例(97.4%);Ⅲ级切除(部分切除)1例(2.6%)。术后1年随访,症状缓解34例(90%),稳定2例(5%),加重2例(5%)。McCormick脊髓功能分级Ⅰ级30例,Ⅱ级6例,Ⅲ级2例。无颅内感染及脑脊液漏等并发症,无死亡病例。结论MRI检查是脊膜瘤最佳的辅助检查手段,显微手术切除是治疗椎管内脊膜瘤的根本方法,其疗效良好,术后并发症少。

Objective To investigate the experience and skill of microsurgery for intra-spinal meningioma to improve its clinical effect.Methods Clinical data,imaging data and follow-up data of 38 patients with intra-spinal meningioma undergoing microsurgery were analyzed retrospectively.Results All the tumors were confirmed as meningioma by pathological examination.According to the Simpson grade of meningiomas,grade I was seen in 32 patients,grade II in 5,and 37 patients(97.4%)with gradeⅠorⅡwere treated as total tumor resection,while 1 patient(2.6%)with gradeⅢas partial tumor resection.During a follow-up period of 1 year,the symptom was relieved in 34 patients(90%),remained stable in 2(5%)and aggravated in 2(5%).There were 30 patients with grade I,6 with gradeⅡand 2 with gradeⅢaccording to McCormick grade of spinal function.There was no intracranial infection,cerebrospinal fluid leakage or other complications,and no patient died.Conclusions MRI is the best auxiliary examination means for intra-spinal meningiomas.And microsurgery is the basic treatment method with better therapeutic effect and fewer postoperative complications.