L5腰髓海绵状血管瘤合并L4～5退行性腰椎滑脱一次性手术治疗1例报道  

作　　者：孙伟[1] 刘卫东[1] 伊藤康信 杜茂信[1] 钱忠心[1] 

机构地区：[1]上海市浦东新区浦南医院神经外科,上海200000 [2]财团法人脑神经疾患研究所附属综合南东北医院神经外科

出　　处：《当代医学》2014年第15期1-4,共4页Contemporary Medicine

基　　金：上海市浦东新区卫生局重点学科群建设项目资助(PWZxkq 2011-02);上海市卫生局医学重点专科建设项目资助(ZK 2012 A 31);上海市浦东新区卫生系统优秀青年医学人才培养(PWRq 2013-13)

摘　　要：目的：探讨腰髓海绵状血管瘤和腰椎滑脱的临床表现、病理特点、影像学特征、治疗及预后。方法某55岁女性患者，经腰椎X线、CT和MRI检查拟诊为L 4～5腰椎退行性滑脱、腰椎管狭窄伴L 5硬膜内髓外肿瘤，并行双侧L 4椎板切除减压术、L 4～5的PLIF＋螺丝内固定和肿瘤切除术的外科手术治疗。结果术后患者左下肢和左侧臀部疼痛感消失，术后行走无明显不适。术后CT无明显异常，显示减压充分、固定满意。术后随访1年，患者无明显不适，生活自理。结论脊髓海绵状血管瘤和腰椎滑脱同时在一次手术报道不多，小心操作，充分减压、保护神经，建立坚强的内固定融合椎体是确保此类手术成功的关键。Objective To explore the clinical manifestations, pathological features, radiological features, treatment and prognosis of the spinal cavernous hemangioma and degenerative lumbar spondylolisthesis. Methods The minimally invasive surgery was preformed in a patient, who was female, 55-year-old, with left hip and left lateral thigh pain in 4 years, but had some effects with conservative treatment. One month ago before admission, she had suffered the left lower extremity pain significantly and much difficulty in walking, even intermittent claudication. The main imaging manifestations of the lumbar spine X-ray, CT and MRI included L 4-5 lumbar degenerative spondylolisthesis, lumbar spinal stenosis and L 5 intradural extra medullary tumor. The one-time surgery was performed, which was L 4~5 degenerative spondylolisthesis＆amp;intradural tumor at L 5,PLIF＋pedicle screw, bilateral L 4 laminectomy and decompression. Results Postoperative patient had no symptom with left leg and left hip pain and no walking problems.Postoperative CT showed no obvious abnormality, sufficient decompression,fixation were satisfactory. The patient was followed up for one year,with not any discomfort, and can take care of herself. Conclusion The case was few reported, of one-time operation of spinal cord cavernous hemangioma associated with lumbar spondylolisthesis. The sufficient decompression, carefully protecting the nerve, build strong internal fixation fusion of vertebral body is the key to ensure the success of such operations.

关 键 词：脊柱海绵状血管瘤 腰椎滑脱症 脊柱融合术 显微外科 

分 类 号：R687.3[医药卫生—骨科学]