髓外硬膜内肿瘤诊断与手术治疗分析

《髓外硬膜内肿瘤诊断与手术治疗分析》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、·344·颈腰痛杂志2010年第31卷第5期TheJournalofCervicodyniaandLumbodynia2010，Vo1．31No．5●临床研究●髓外硬膜内肿瘤诊断与手术治疗分析柯楚群，何伟东，梁寒洁，林毅忠，杨明明(江门市人民医院骨科，广东江f-3529051)摘要：目的探讨髓外硬膜内肿瘤的诊断及手术治疗效果。方法回顾分析我院1996年6月2009年l2月期间治疗的23例髓外硬膜内肿瘤。肿瘤位于颈段2例，胸段16例，腰段5例。神经鞘瘤l4例，脊膜瘤8例，神经纤维瘤1例。出现症状至确诊时间1月～6年。采用CTM诊断4例，用MRI诊断19例。术前JOA评分4～

2、15分，平均8．7分。全部病例均以后路手术切除肿瘤。结果手术均完全切除肿瘤。随访6个月～13年，平均1年6个月。所有患者神经功能障碍均有明显改善或缓解，其中2例未完全恢复。术后半年时JOA评分12．7分(10一l7分)。全部病例均未见复发，且脊柱稳定性良好。结论髓外硬膜内肿瘤易于误诊漏诊，临床可疑者，MRI或CTM检查可帮助确诊；后路全椎板切除或椎管后中央扩大开窗均可充分显露并彻底切除肿瘤。关键词：髓外硬膜下肿瘤；脊柱；诊断；手术治疗中图分类号：R739．43文献标识码：B文章编号：1005—7234(2010)05—0344—04Clinicalanalysisofdi

3、agnosisandsurgicaltreatmentofextramedullaryintraduraltumorsKEChu—qun，HEWei—dong，LIANGHan-jie，eta1．(DepartmentofOrthopedics，People’SHospitalofJiangmenCity，Guangdong，529051，China)Abstract：ObjectiveToexploretheclinicaleffectofdiagnosisandsurgicaltreatmentofex-tramedullaryintraduraltumors．Met

4、hodsThesurgicalresultsof23casesofextramedullaryintradu-raltumorduringtheperiodsfrom1996to2009wereanalyzed．Thetumorswerelocatedatthecervicalareain2cases，atthethoracicregionin16casesandatthelumbarregionin5cases．Th~rewereneurinomain14patients，meningiomain8casesandneurofibromain1ease．Meandura

5、tionofsymptomspriortodiagnosiswere24months(1to84months)．MR1wasusedin19casesandCT—myelographywereusedin4easesfordiagnosis．JOAscoreofallpatientswererecordedpreoperative．therewere4to15cores(mean8．7cores)．Laminectomyandtumorresectionin7cases．posterocentralenlargedfenestrationofspinalcanalandt

6、umorresectionin16cases．In-ternalfixationwithpediclescrewin2cases．ResultsAgrosstotalresectionwereachievedinallpatientsatthetimeofsurgery．Thepatientswerefollowedupfrom6to156monthswithanaver-ageof18months．ThepostoperativerecoveryofneurologicalfunctionweremeasuredwithJOAscoreat6monthsafterthe

7、operation．therewere10to17cores(mean12．7cores)．Thepatientsshowednotumorrecurrenceandnospinalinstability．ConclusionExtramedullaryintraduraltumorsareeasilymisdiagnosed．MRIorCT—myelographymaybehelpfulintheexactdiagnosisofex-tramedullaryintraduraltumors．Thetumorsthatcanb