颈段椎管内肿瘤的显微手术治疗  

Microsurgical treatment of tumors in cervical spinal canal

作　　者：王辉[1] 石德金[1] 李文胜[1] 梁朝峰[1] 何海勇[1] 秦峰[1] 叶卓鹏[1] 郭英[1] 

机构地区：[1]中山大学附属第三医院神经外科,广州市510630

出　　处：《中华显微外科杂志》2008年第6期417-419,共3页Chinese Journal of Microsurgery

摘　　要：目的 报道颈段椎管内肿瘤显微手术的临床疗效。方法颈段椎管内肿瘤32例，均采用后正中入路显微手术，术后22例进行颈椎稳定性重建。结果肿瘤全切26例，占81．25％，肿瘤大部分切除6例（包括3例星形细胞瘤，3例包裹并紧密粘连椎动脉的哑铃形神经鞘瘤），占18．75％。按George的方法评估，恢复良好23例（71．88％），症状改善6例（18．75％），无明显改善3例（9．38％），无手术死亡。30例随访3个月～3年。26例术后3个月MR检查未见肿瘤残存或复发，1例神经鞘瘤维持术后大小未增大．3例星形细胞瘤复发。术后X线检查其中4例出现颈椎不稳，26例稳定性良好。结论早期显微手术是颈段椎管内肿瘤的关键治疗手段，术后重建椎管的稳定性对患者的远期恢复意义重大。Objective To report effects of microsurgical treatment for tumors in cervical spinal canal. Methods A total of 32 cases of tumors in cervical spinal canal had received microneurosurgery through a posterumedial approach. 22 cases had received reconstruction of cervical spinal canal stability. Results A total tumor resection was performed in 26 cases （81.25%）,a subtotal tumor resection was conducted in 6 cases （18.75%）. A complete recovery was achieved in 23 cases （71.88%）, an improvement of symptoms was achieved in 6 cases（18.75%）, and no improvement in 3 cases（9.38%）, no death was encountered. Follow up observations were carried out in 30 cases for 3 months to 3 years. MRI examinations 3 months after operation in 26 cases found no residual or recurrent tumor,recurrence was seen in 3cases of astrocytoma, 1 case was invariable. X-ray radiography in 26 cases showed good vertebral stability, spinal deformation was found in 4 eases. Conclusion Microsurgery in early period play a key role in treatment of cervical spinal tumors. Reconstruction of spinal canal stability is important to patients.

关 键 词：颈椎 脊髓肿瘤 重建 显微手术 稳定性 

分 类 号：R686[医药卫生—骨科学]