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目的总结治疗椎管内肿瘤的经验。方法回顾性分析 163例经手术治疗、有明确病理诊断的椎管内肿瘤的病理类型与部位、临床症状和体征、影像学检查及手术治疗的方法和疗效。结果本组椎管内肿瘤中神经鞘膜瘤 5 8例 (3 5 .5 8% ) ,脊膜瘤 2 8例 (17.18% ) ,星形细胞瘤 11例 (6.75 % )、表皮样囊肿 10例 (6.13 % ) ,室管膜瘤和血管瘤各 8例 (4.91% ) ,脂肪瘤和畸胎瘤各 7例 (4.2 9% ) ,皮样囊肿 6例 (3 .68% ) ,蛛网膜囊肿 14例 (8.5 9% ) ,另有少见的肠源性囊肿、节细胞神经瘤和转移瘤。本组病例硬膜外肿瘤占 14.72 % ,髓外硬膜下肿瘤占 63 .19% ,髓内肿瘤占 2 2 .0 9%。肿瘤位于颈段占 3 1.90 % ,胸段占 41.10 % ,腰段占 19.63 % ,骶段占 7.3 6%。肿瘤全切除率 71.78% ,其中髓外肿瘤全切除率达74.80 % ,髓内肿瘤全切除率 61.11%。术后出院时 82 .82 %的病例症状有不同程度的改善 ,其中疼痛得到缓解的最多。有 11.0 4%的病例症状较术前无变化 ,另有 6.13 %的病例术后症状加重。结论椎管内肿瘤 3 / 4为良性 ,故手术全切除后预后良好 ,MRI检查和显微外科技术的应用提高了椎管内肿瘤的全切除率
Objective To summarize the experience of treatment of spinal canal tumor. Methods Retrospective analysis of 163 cases of surgical treatment, a clear pathological diagnosis of spinal canal tumor pathology and location, clinical symptoms and signs, imaging examination and surgical treatment methods and efficacy. Results Fifty-eight cases (35.58%) of neurofibromatosis, 28 cases (17.18%) of meningioma, 11 cases (6.75%) of astrocytomas, 10 cases of epidermoid cysts (6.13%), ependymoma and hemangioma in 8 cases (4.91%), lipoma and teratoma in 7 cases (4.2%), dermoid cysts in 6 cases (3.68% Cysts in 14 cases (8.5 9%), and another rare enterogenous cysts, ganglioneuromas and metastases. The group of patients with epidural tumors accounted for 14.72%, extramedullary subdural tumors accounted for 63.19%, intramedullary tumors accounted for 22.09%. The tumor was located in the neck of 3 1.90%, thoracic 41.10%, lumbar 19.63%, sacral 7.3.6%. The total resection rate of tumor 71.78%, of which extramedullary tumor resection rate of 74.80%, intramedullary tumor total resection rate of 61.11%. At 82.82% of the cases were discharged from the hospital, the symptoms of the patients were improved to some extent, of which the pain was relieved most. There were 11.0 4% of cases no change in symptoms than before surgery, while another 6.13% of the cases postoperative symptoms worsened. Conclusion 3/4 of the spinal canal tumor is benign, so the prognosis is good after total resection. The application of MRI and microsurgical techniques improves the total resection rate of the tumor in the spinal canal