【摘要】 目的总结椎管内神经鞘瘤的诊治经验。方法回顾性分析25例椎管内神经鞘瘤病例的临床资料,均经影像学和病理学确诊,其中颈段5例,上、中胸段8例,下胸段4例,胸腰段2例,腰段6例。均在全麻下施行手术,行囊内切除6例,囊外切除19例。12例下胸段、胸腰段或腰段病例同期行后路椎弓根钉棒系统内固定并后外侧植骨融合。结果25例均完整切除肿瘤,术后脑脊液漏4例,无其他并发症。25例均获随访,平均2.7(0.5~5)年,术后感觉和运动ASIA评分分别为(202.6±11.4)分和(89.9±7.3)分,较术前的(148.6±6.2)分和(56.7±5.3)分有明显改善(P<0.01)。结论MR I对椎管内神经鞘瘤有较高的定位、定性诊断准确率,手术彻底切除肿瘤可获得满意疗效。更多还原

【Abstract】 Objective To summarize the experiences of the diagnosis and surgical treatment of intraspinal neurinoma. Methods 25 intraspinal neurinoma cases were diagnosed by imaging examinations and pathological results.The intraspinal neurinoma located in cervical segments in 5 cases,upper or middle thoracic segments in 8 cases,lower thoracic segments in 4 cases,thoracolumbar segments in 2 cases,and lumbar segments in 6 cases.All patients were performed tumor excision,including 6 of intracapsular excision and 19 of extracapsular excision.Posterior internal fixation with pedicle screw systems and posterolateral bone grafting was conducted simultaneously in 12 cases involved in lower thoracic,thoracolumbar or lumbar segment. Results The neurinoma was resected completely in all cases.Cerebrospinal leakage was found in 4 cases and cured by trendelenburg position.All patients were followed up for 0.5 to 5 years,with an average of 2.7 years.The preoperative and postoperative ASIA Score of sensation was 148.6±6.2 vs 202.6±11.4,and motion score was 56.7±5.3 vs 89.9±7.3,respectively.The nerve function were achieved obviously improvement after the operation(P <0.01). Conclusion For intraspinal neurinoma,MRI is a good diagnosis method with high located and qualitative diagnosis rate,and surgical excision can achieve a satisfactory result.更多还原