目的 探索椎管原发性肿瘤致截瘫原因,分析采用显微外科技术摘除肿瘤疗效。方法对23例原发性椎管肿瘤致截瘫病例进行治疗,对其致瘫的原因、临床特点、影像学改变进行分析。结果 经术后3～26个月随访,依据美国脊柱损伤学会对Frankel脊髓损伤修订分级标准评定:除2例术后截瘫无改善外,其它21例瘫痪基本恢复。结论 详细的病史收集、系统的物理检查、高质量影像检查与分析,是早期诊断的关键;避免盲目性推拿、按摩、牵引是预防突发性截瘫或截瘫加重的重要环节;显微外科技术切除肿瘤,具有解剖层次分明,肿瘤切除彻底,对脊髓、神经根干扰小的优点,其疗效更令人满意。 Objective To explore the causes of paraspinal paraplegia caused by primary spinal canal tumor and analyze the curative effect of microsurgery for tumor removal. Methods Twenty-three patients with paraplegia caused by primary spinal tumor were treated, and their causes, clinical features and imaging changes were analyzed. Results After 3 to 26 months follow-up, according to the American Society of Spine Injury Frankel spinal cord injury revised grading standards assessment: except for 2 cases of paraplegia without improvement, the other 21 cases of paralysis recovered. Conclusion The detailed medical history collection, systematic physical examination and high-quality image examination and analysis are the keys to early diagnosis. Avoid blind massage, traction is an important part of prevention of sudden paraplegia or paraplegia; microsurgical resection Tumor, with distinct anatomy, complete tumor resection, spinal cord, nerve root interference, the advantages of less, the effect is more satisfactory.