单开门椎管后部结构重建治疗儿童椎管内良性肿物  

Treatment for the intraspinal tumor with open-door laminoplasty in children

作　　者：李玉伟[1] 严晓云[1] 王海蛟[1] 王玉记[1] 马培栋[1] 谢广田[1] 

机构地区：[1]河南省漯河市中心医院脊柱科,462000

出　　处：《中国脊柱脊髓杂志》2008年第2期99-102,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨单开门椎管后部结构重建治疗儿童椎管内良性肿物的可行性及临床效果。方法:2001～2006年共收治椎管内肿物7例,男5例,女2例,年龄1～11岁。颈段1例,胸段4例,腰段2例。神经鞘瘤、脊膜瘤、室管膜瘤(良性)各2例,肠源性囊肿1例。占据1.5～4个脊髓节段。手术采用单开门椎管成形、显微切除椎管内肿物、椎板棘突复合体复位"关门"重建椎管。结果:本组椎板开门2～4个,平均2.5个,均顺利实施手术。术后临床症状完全或大部分消失,无椎管内血肿引起脊髓压迫症状的病例发生。6例得到随访,随访3个月～5年,平均28个月。X线片示脊椎序列正常,未见脊柱侧后凸等畸形。5例复查CT显示椎板棘突复合体无移位。6例复查MRI,椎管内肿瘤切除彻底无复发,无椎管狭窄,未见椎管后部畸形改变。结论:单开门椎管后部结构重建治疗儿童椎管内良性肿瘤,最大可能保护了儿童脊柱的解剖结构,可避免椎板切除术后脊柱畸形的发生。Objective：To introduce a method to deal with intraspinal tumor in children and evaluate its clinical effect.Method：7 children （2 females,5 males） with intraspinal neoplasm from 2001 to 2006 were reviewed retrospectively,the range of age was 1-11 years old.Of these cases,there was 1 case involving cervical spine,4 cases involving thoracic spine,2 cases involving lumbar spine.There were 2 cases of neurilemmoma,2 cases of meningioma,2 cases of ependymoma,1 case of enterogenous cyst.The involved segments were 1.5-4. All cases underwent open-door laminoplasty,intraspinal removal of neoplasm and reconstruction of posterior elements.Result：The number of lamina opened was 2-4,with an average of 2.5.All surgery were performed successfully with theneurological deficit improved satisfactorily.6 cases were followed-up with the mean follow- up of 28 months （range,3-60 months）.The spine alignment were kept normal with no kyphosis noted,spinal canal stenosis and spinal deformities.All cases were primary healing;the preoperative symptoms recovered satisfactorily during the following-up.The open-door lamina achieved bone fusion without stenosis and spinal deformities.Conclusion：The open-door laminoplasly can restore the posterior construction and maintain the stability of the spine without recurrence of stenosis,and effectively decrease the rate of spinal deformities.

关 键 词：椎管内肿瘤 儿童 单开门椎管成形术 

分 类 号：R739.42[医药卫生—肿瘤]