高位颈段椎管内神经鞘瘤显微手术治疗59例  

Microsurgical treatment of neurilemmoma in upper cervical spinal canal： 39 cases report

作　　者：王林[1] 傅先明[1] 牛朝诗[1] 钱若兵[1] 凌士营[1] 计颖[1] 汪业汉[1] 

机构地区：[1]安徽医科大学附属省立医院神经外科,合肥230001

出　　处：《中华显微外科杂志》2011年第1期34-37,共4页Chinese Journal of Microsurgery

摘　　要：目的 探讨高位颈段神经鞘瘤显微手术技巧和疗效.方法从2004年1月至2007年12月,对59例均采用后正中入路显微手术治疗,采用德国产Laika显微镜下切除肿瘤,较大肿瘤不能完整切除时,用分块切除或囊内切除,术后常规颈托限制颈部活动,55例术后随访6个月～2年.结果 痊愈54例,症状改善5例,无死亡.55例随访6个月～2年,4例失访.35例术后3～12个月MR检查未见肿瘤残存或复发,42例术后6个月颈椎正侧位及张口位片检查未见脊柱骨性结构变形,脊柱稳定性好.结论 高位颈段神经鞘瘤一旦确诊,就应该及早显微手术治疗.手术安全、效果良好.Objective To explore surgical techniques and curative effects of microsurgical treatment for neurilemmoma in upper cervical spinal canal. Methods From Jan. 2004 to Nov. 2007, 59 cases of schwannoma was resected through microoperation, the operation was conducted through a posteromedial approach, using German Laika microscope resection of the tumor, large tumors cannot complete resection,block or sac, resection postoperative neck activity conventional neck restrictions, with following observation of 6 months-2 years. Results A complete recovery was achieved in 54 cases, an improvement of symptoms was achieved in 5 cases, no death was encountered. Follow-up observations were carried out in 55 cases from 3 months-2 years （6.5 ± 1.5 months）. MRI examinations 3-12 months after operation in 35 cases found no residual or recurrent tumor. X-ray radiography under anteroposterior, lateral, and open-mouth view 6 months after operation in 42 cases showed no spinal deformation and good vertebral stability. Conclusions As long as neurilemmoma in upper cervical spinal canal are diagnosed, a microsurgical treatment should be given as early as possible. Appropriate selection of surgical approach, skillful microsurgical techniques in accordance with pathological types of lesions, and principles of minimal invasion are critical for the operation safety.

关 键 词：颈段椎管 神经鞘瘤 显微外科手术 

分 类 号：R739.4[医药卫生—肿瘤]