复发性椎管内肿瘤的显微外科治疗

Microsurgical Treatment of Recurrent Intra-spinal Canal Tumors

目的 探讨椎管内肿瘤术后复发的显微外科治疗体会。方法 对 1993 -0 6～ 2 0 0 2 -0 6收治的 16例复发性椎管内肿瘤的病例进行回顾性研究 ,分析其显微外科手术特点、手术方法、手术结果及手术并发症等。结果 显微镜下全切除 10例 ,近全切除 4例 ,大部切除 2例。出院时症状体征改善者 10例 ,无变化 3例 ,加重 3例。随访 5个月至 8年 ,良好者 11例 ,残废 4例 ,死亡 1例。结论 椎管内肿瘤复发经确诊 ,再次手术效果良好 ,但术中须更加小心 ,注意脊髓功能的保护。对恶性肿瘤或切除不完全者应行放射治疗。

Objective To explore the microneurosurgical treatment of recurrent intra-spinal canal tumors. Methods The clinical data on the microsurgical parameters, operative procedures, operative efficacy and post-operative complications of 16 cases with recurrent intra-spinal canal tumors from June 1993 to June 2002 were reviewed retrospectively. Results Under the operative microscope, the tumors were totally removed in 10 cases, subtotally in 4 cases, and partially in 2 cases. Fllowed up from 5 months to 8 years, 11 cases recovered well, 4 cases suffered from moderate disability, and 1 case died. Preoperative CT or MRI scan, knowledge of the anatomy and structures, and skillful operative techinique all were important to microsurgical treatment of recurrent intra-spinal canal tumors. Conclusion Once diagnosis of recurrent intra-spinal canal tumors, the operative treatment is effective. Radiation therapy for the malignant tumors or incompletely removed recurrent tumors is necessary.