颈椎后路肿瘤摘除植骨融合内固定治疗颈椎管内肿瘤的临床分析  

Treatment of cervical intraspinal tumor by tumorectomy,bone graft fusion and internal fixation via posterior approach:a clinical analysis

作　　者：陶海鹰[1] 贺斌[1] 卫爱林[1] 陶凤华[1] 李孝海[1] 

机构地区：[1]武汉大学人民医院脊柱外科

出　　处：《临床外科杂志》2015年第1期58-60,共3页Journal of Clinical Surgery

摘　　要：目的：探讨颈椎后路肿瘤切除植骨融合内固定治疗颈椎管内肿瘤的疗效。方法手术治疗颈椎管内肿瘤16例（神经鞘瘤9例，脊膜瘤4例，神经纤维瘤3例），16例在切除肿瘤后均行颈椎后路椎弓根螺钉内固定及植骨融合术，术中行脊髓神经电生理监测对脊髓功能进行判断，术前术后行 JOA 评分。结果本组16例均后路一次手术完全切除肿瘤，术中脊髓监测均无脊髓损伤发生，平均随访12个月（3~29个月），JOA 评分有明显改善，肿瘤无复发，术后无脊髓损伤或症状加重，无血管、神经损伤等并发症发生，术后无内固定松动或断裂发生，固定效果满意，术后复查 X 线及 CT 提示相应植骨部位均形成骨性融合。结论颈椎管内肿瘤行后路肿瘤切除及椎弓根螺钉内固定可取得良好的临床疗效。Objective To investigate the efficacy of posterior tumorectomy,bone graft fusion and internal fixation for cervical intraspinal tumor. Methods A total of 16 cases of cervical intraspinal tumor were enrolled and received surgical treatment,including 9 cases of schwannoma,4 cases of meningioma and 3 cases of neurofibroma. All patients accepted posterior cervical pedicle screw fixation and bone graft fusion after tumorectomy. Electrophysiological activity of the spinal nerves was monitored during the operation and JOA score was analyzed before and after operation. Results All tumors in the 16 patients were primarily removed. Intraoperative electrophysiological monitoring revealed no spinal cord injuries. The follow-up time ranged from 3 to 29 months,with an average of 12 months. Patients＇ JOA scores were obviously improved. There were no recurrence,spinal cord injuries and deterioration,vascular and nerve injuries and loose or broken fixation. Postoperative X-ray and CT scan indicated posterolateral bone graft fusion. Conclusion Posterior tumorectomy and cervical pedicle screw fixation can achieve good clinical efficacy in the treat-ment of cervical intraspinal tumor .

关 键 词：颈椎管肿瘤 后路内固定术 

分 类 号：R739.4[医药卫生—肿瘤]