颈肩腰腿疼与椎管内肿瘤

Relation of the Neck Shoulder Low Back and Leg Pain with the Intraspinal Tumors

目的 :探讨椎管内肿瘤的早期诊断方法及治疗经验。方法 :回顾性分析过去 2 0年我院对 85例椎管内肿瘤的手术效果。结果 :神经鞘膜瘤 30例 ,脊膜瘤 16例 ,表皮样囊肿 12例 ,脂肪瘤 5例 ,畸胎瘤 7例 ,神经纤维瘤 4例 ,血管瘤 4例 ,脊髓囊肿 3例 ,室管膜瘤 2例 ,胶质细胞瘤 2例。肿瘤位于颈段 6例 ,胸段 32例 ,胸腰段 31例 ,腰段 16例。上述肿瘤位于硬膜外 12例 ,占 14 % ,硬膜内 73例 ,占 86 %。肿瘤全切率 89.2 %。随访 1～ 15a ,痊愈 72例 (84 .7% ) ,好转 7例 (8.2 % ) ,差 4例 (4 .7% ) ,死亡 2例 (2 .4 % )。结论 :椎管内肿瘤临床表现以颈肩腰腿疼为主 ,治疗效果取决于肿瘤部位 ,性质 ,大小及发病后就诊时间 ,早期诊断与早期治疗是预后的关键。MRI。

Objective:To study the early diagnosis and surgical treatments.Methods:From 1982 to 2002,85 patients with intraspinal tumors were analysed.Results:The pathological types:the neurilemoma were 30 cases.Meningioma 16 cases,epidermoid cystis 12 cases,teatoma 7 cases,lipoma 5 cases.Neurohibrama 4 cases,Ntradura cystis 2 cases,hemangioma 4 cases.Spinal cord cyst 3 cases,glioma 2 cases,ependymoma 2 cases.Of 85 patients the position of the disease:the cervical were 6 cases,thoracic 32 cases,the thoracic and lumbar 31 cases,and lumbar 16 cases.The total removal of tumors was got in 89.2 % cases.All patients were followed up from 1 to 15 years.Excellent was 72 cases(84 %).Conclusion:The good results depend on the tumors location,size,histologic differentiation and the time of primary surgical resection.To use MRI and Myelograthy imaging for early diagnosis is necessary.