论文部分内容阅读
目的:探讨颈椎椎管内外沟通性肿瘤的临床特点及手术治疗策略。方法:回顾性分析2008年6月-2015年1月收治的17例经手术治疗的颈椎椎管内外沟通性肿瘤患者。男:女=9:8;平均年龄:43.5岁,均为成人。肿瘤部位:颈1~颈2 3例,颈3~颈5 7例,颈4~颈6 5例,颈5~颈7 2例。手术方式:14例先由神经外科医师切除椎管内肿瘤至椎间孔,再由头颈外科医师切除椎管外的肿瘤;3例因肿瘤的大部位于椎管外颈部而椎管内肿瘤较小对脊髓的压迫不明显,先由头颈外科医师切除椎管外肿瘤,再由神经外科医师切除椎管内肿瘤。结果:本组肿瘤均完全一期切除。肿瘤性质:神经鞘瘤15例,神经纤维瘤1例,神经节细胞瘤1例。随访时间4个月-6年,平均18个月。术后所有病例疼痛明显改善,感觉麻木面积扩大1例,肢体运动功能改善11例。无肿瘤复发,无继发脊柱畸形。结论:大多数颈椎椎管内外沟通性肿瘤均可通过显微手术一期全切。因椎管内外沟通性肿瘤解剖关系复杂,毗邻重要结构,手术难度较大,往往需要进行多个学科间的密切合作。
Objective: To explore the clinical features and surgical treatment strategies of cervical and internal tumor with communicating tumors. Methods: A retrospective analysis of 17 patients with surgically-treated cervical and internal tumor communicating with tumors from June 2008 to January 2015 was performed. Male: Female = 9: 8; average age: 43.5 years, both adults. Tumor site: neck 1 ~ neck 2 3 cases, neck 3 ~ neck 57 cases, neck 4 ~ neck 65 cases, neck 5 ~ neck 7 2 cases. Surgical methods: 14 cases of neurosurgeons first excision of spinal canal tumor to the intervertebral foramen, then the head and neck surgeons excision of the tumor outside the spinal canal; 3 cases of most of the tumor in the spinal canal and spinal canal tumor Small oppression of the spinal cord is not obvious, first by the head and neck surgeons excision of the tumor outside the spinal canal, neurosurgeons resection of spinal tumors. Results: The group of tumors were completely removed. Tumor characteristics: Schwannoma in 15 cases, 1 case of neurofibroma, ganglioneuroma in 1 case. Follow-up time of 4 months to 6 years, an average of 18 months. Postoperative pain was significantly improved in all cases, sensory numbness in 1 case of enlargement, limb motor function improved in 11 cases. No tumor recurrence, no secondary spinal deformity. Conclusion: Most of the internal and external cervical spinal canal tumors can be microsurgery a total cut. Due to the complexity of the dissection relationship between the internal and external spinal canal tumor adjacent to the important structure, the surgery more difficult, often requires close cooperation between multiple disciplines.