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目的:探讨单开门椎管后部结构重建治疗儿童椎管内良性肿物的可行性及临床效果。方法:2001～2006年共收治椎管内肿物7例,男5例,女2例,年龄1～11岁。颈段1例,胸段4例,腰段2例。神经鞘瘤、脊膜瘤、室管膜瘤(良性)各2例,肠源性囊肿1例。占据1.5～4个脊髓节段。手术采用单开门椎管成形、显微切除椎管内肿物、椎板棘突复合体复位“关门”重建椎管。结果:本组椎板开门2～4个,平均2.5个,均顺利实施手术。术后临床症状完全或大部分消失,无椎管内血肿引起脊髓压迫症状的病例发生。6例得到随访,随访3个月～5年,平均28个月。X线片示脊椎序列正常,未见脊柱侧后凸等畸形。5例复查CT显示椎板棘突复合体无移位。6例复查MRI,椎管内肿瘤切除彻底无复发,无椎管狭窄,未见椎管后部畸形改变。结论:单开门椎管后部结构重建治疗儿童椎管内良性肿瘤,最大可能保护了儿童脊柱的解剖结构,可避免椎板切除术后脊柱畸形的发生。
Objective: To investigate the feasibility and clinical effect of single-door posterior spinal canal reconstruction for the treatment of benign tumor in children’s spinal canal. Methods: From 2001 to 2006, 7 cases of spinal canal tumor were treated, including 5 males and 2 females, aged from 1 to 11 years old. 1 case of cervical, 4 cases of thoracic and 2 cases of lumbar. Schwannoma, meningioma, ependymoma (benign) in 2 cases, 1 case of enterogenous cysts. Occupy 1.5 to 4 spinal segments. Operative single-door spinal canal, micro-resection of spinal canal tumor, lamina spinous process complex reset “close ” reconstruction of the spinal canal. Results: This group of open lamina 2 to 4, an average of 2.5, were successfully implemented. Postoperative clinical symptoms completely or largely disappeared, no intraspinal hematoma caused by spinal cord compression symptoms occurred. 6 cases were followed up for 3 months to 5 years, an average of 28 months. X-ray showed spine sequence was normal, no deformity such as scoliosis. Five cases of recurrent CT showed no displacement of lamina spinous process complex. 6 cases of MRI review, complete excision of spinal canal tumor recurrence, no spinal stenosis, no change in posterior deformity. CONCLUSION: Reconstruction of single-door spinal canal posterior structures in children with benign tumors of the spinal canal maximizes the anatomy of the spine of children and avoids the occurrence of spinal deformity after laminectomy.