椎管内表皮样囊肿及皮样囊肿和畸胎瘤的治疗

Treatment of epidermoid cyst, dermoid cyst and teratoma in spinal canal

目的 研究椎管内表皮及皮样囊肿和畸胎瘤的治疗及预后。方法 1972～1999年共收治这类先天性椎管内肿瘤36例,其中表皮样囊肿18例,皮样囊肿10例,畸胎瘤8例。对18例患者行囊内肿物清除,囊壁外翻缝合;8例囊壁全切;10例囊壁大部切除。结果 24例获得8月～16年随访,囊壁外翻缝合12例,9例恢复好,1例感染,但术后4例复发。囊壁全切5例,2例加重。囊壁次全切除7例,症状无加重,术后1例复发。结论 此类肿瘤位于颈、胸段髓,可行囊壁全切,位于胸腰段及腰段,根据情况行囊壁次全切除。MRI为诊断和治疗此类肿瘤提供了较多信息。

Objective To study the surgical treatment and prognosis of epidermoid cyst, dermoid cyst and tera-toma in spinal canal. Methods Thirty - six patients with these kinds of congenital tumors in spinal canal were treated from 1972 to 1999. There were 18 epidermoid cysts, 10 dermoid cysts and 8 teratomas. Of 36 cases, 18 cases underwent intralesional resection, 8 cases total resection and 10 cases subtotal resection. Results Twenty - four patients were followed up from 8 months to 16 years. Of 12 cases undergone intralesional resection, good results showed in 9 cases, infection occurred in 1 case, recurrences were seen in 4 cases. Of 5 cases undergone total resections, exacerbations were seen in 2 cases. Of 7 cases undergone subtotal resections, recurrence occurred in 1 case and without exacerbation. Conclusions If these congenital tumors locate at extramedullary spinal cord of cervicothoracic and thoracic region, total resection should be the choice. If the tumors locate at thoracolumbar or lumbar region, subtotal resection can be selected accordingly. MRI could provide more information for diagnosis and surgical treatment.