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目的探讨连续型多节段椎管内肿瘤患者的临床特点及外科治疗。方法对2005年-2010年接收手术治疗的9例连续型多节段(>3个节段)椎管内肿瘤患者的临床资料进行回顾性分析。男3例,女6例;年龄36-71岁,平均年龄52.2岁。病变位于胸段、胸腰段、腰段;髓外硬脊膜下8例,硬脊膜外1例。均行显微手术切除肿瘤并行椎弓根螺钉融合内固定术。结果本组患者肿瘤全切除5例,次全切除4例。术后无四肢瘫痪及死亡病例。随访3-38月,症状完全消失2例,好转5例,无变化1例,加重1例。结论连续型多节段椎管内肿瘤起病隐匿,临床表现缺乏特异性,早期确诊率低。一经发现尽可能切除肿瘤,但应避免神经损伤。术中注意重建脊柱稳定性,预防术后出现脊柱后凸或侧凸畸形。患者术前神经功能状态和病程长短是决定预后的重要因素。
Objective To investigate the clinical features and surgical treatment of patients with continuous multi-segment spinal canal tumor. Methods The clinical data of 9 consecutive patients with multi-segment (> 3-segment) intraspinal tumors undergoing surgery from 2005 to 2010 were analyzed retrospectively. 3 males and 6 females; aged 36-71 years, mean age 52.2 years old. Lesions in the thoracic, thoracolumbar, lumbar; extramedullary subdural in 8 cases, 1 cases of epidural. All patients underwent microsurgical resection of the tumor with pedicle screw fusion and internal fixation. Results In this group, 5 cases were completely excised tumor and 4 cases were subtotally resected. No limb paralysis and death after surgery. Follow-up 3-38 months, the symptoms disappeared in 2 cases, improved in 5 cases, no change in 1 case, an increase of 1 case. Conclusions Continuous multi-segment spinal canal tumor is occult, its clinical manifestations are not specific, and the early diagnosis rate is low. Once discovered as possible resection of the tumor, but should avoid nerve damage. Surgery to pay attention to the reconstruction of spinal stability, prevention of postoperative kyphosis or scoliosis deformity. Preoperative neurological status and duration of disease is an important factor in determining the prognosis.