误诊为腰椎间盘突出症的椎管内肿瘤11例诊断及治疗  

The diagnosis and surgical treatment of intraspinal tumors: A report of 11 missed cases

作　　者：沈万安[1] 范清宇[1] 马保安[1] 程虹[2] 

机构地区：[1]第四军医大学唐都医院全军骨肿瘤研究所,陕西西安710038 [2]第四军医大学西京医院病理科,陕西西安710032

出　　处：《现代肿瘤医学》2007年第4期555-556,共2页Journal of Modern Oncology

摘　　要：目的:分析椎管内肿瘤误诊为腰椎间盘突出症的原因及治疗。方法:分析11例误诊为腰椎间盘突出症的椎管内肿瘤患者的临床表现、诊断和手术治疗。结果:术前所有误诊患者排除腰椎间盘突出症诊断,MRI检查后行手术治疗,手术切除标本经病理诊断为:神经鞘瘤8例,其中椎管内外哑铃状1例;脊膜瘤2例,血管脂肪瘤1例。所有病变均完全切除。术后随访6个月～3年,功能基本全部恢复者9例,残留右小腿外侧麻木1例,左侧臀部麻木1例,无死亡病例。结论:综合分析腰腿痛患者的临床特点与CT检查结果,才能避免误诊;MRI是目前诊断椎管内肿瘤的最有效的手段;及时手术治疗能取得满意的效果。Objective： To study the diagnosis and operative treatment of patients with intraspinal tumors which were misdiagnosed as lumber disc hernia. Methods： Clinical features, diagnosis and operational effect of 11 cases of intraspinal tumors misdiagnosed as lumber disc hernia were analyzed. Results： All 11 patients were excluded the diagnosis of lumber disc hernia before operative treatment and total resection was performed. Histological diagnosis were schwannomas in 8 cases, meningiomas in 2 cases, and angiolipoma in 1 case. In 6 month - 3 year follow - up, 9 patients healed and no patient died. Conclusion： The clinical characteristics of the patients should be analyzed in combination with CT scan findings. Preoperative confirmed diagnosis of intraspinal tumor mainly depends on MRI. According to the tumor sites, adopting different operation ways treatment can gain satisfactory effect in early stage.

关 键 词：椎管内肿瘤 椎间盘突出症 误诊 手术 

分 类 号：R739.4[医药卫生—肿瘤]