椎管内硬膜外神经鞘瘤的诊断和治疗

DIAGNOSIS AND TREATMENT OF EPIDURAL NEURILEMMOMA IN SPINAL CANAL

为了探讨椎管内硬膜外神经鞘瘤的诊断与治疗方法 ,作者分析了 4 2例椎管内硬膜外神经鞘瘤的X线片、MRI和CT的诊断特点 ,观察了患者的围手术期情况、手术治疗的方法和手术前后患者脊髓或神经功能改善的情况、手术时间以及术中出血、输血等。结果显示 ,术后患者神经功能均有明显的恢复 ,MRI结合X线和CT检查显示对病变性质和部位诊断有重要意义。所有患者均行肿瘤切除 ,其中 12例患者在切除肿瘤的同时 ,进行了脊柱植骨内固定 ,防止继发性脊柱不稳定 ,随访示脊柱神经鞘瘤治愈率高。研究表明 ,影像学对神经鞘瘤有较高的诊断率 ,最后确诊依靠病理诊断 ;椎管内神经鞘瘤治愈率高 。

To evaluate the diagnosis and treatment of epidural neurilemmoma in the spinal canal, the diagnostic characteritics shown by X ray, MRI and CT were analyzed in 42 patients. Furthermore, peri operative conditions, operative time, blood loss and amount of blood transfusion during the operation, operative technique, changes in functions of the spinal cord before and after the operation were also analyzed. The results showed that there was marked recovery of nerve functions after the operation. MRI together with X ray and CT were in the diagnosis of the nature and site of the lesion. Excision of the tumor was done in all the patients. Among them, in 12 patients internal fixation was done at the same time. Follow up showed that the operation achieved good results. While radiologic examinations contributed greatly to the diagnosis, the final diagnosis depended on pathological examination. Internal fixation was optional depending on different situations.