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目的探讨椎管内外哑铃型肿瘤的手术治疗策略。方法回顾性分析16例椎管内外沟通性肿瘤的手术治疗经验。3例为已行全椎板切除手术的复发性肿瘤,其他病人均采用半椎板切除或开窗手术。对肿瘤侵犯椎体和受累超过2个节段以上的病例,在切除肿瘤的同时,行相应节段椎体固定融合手术。结果显微镜下均全切除,行椎体固定融合手术3例。术后神经功能症状均明显改善。随访0.5~3.5年,平均2.2年,未见肿瘤复发和术后脊柱畸形。结论椎管内外沟通性肿瘤在颈段较为多见,胸、腰段次之。一次手术全切除较困难,肿瘤全切除后疗效好。对肿瘤侵犯椎体和受累超过2个节段以上的病例应行椎体固定融合术,以维持脊柱稳定。
Objective To investigate the surgical treatment of dumbbell tumor in and without spinal canal. Methods Retrospective analysis of surgical treatment of 16 cases of communicating tumor internal and external spinal canal. Three patients had recurrent tumors undergoing total laminectomy. Other patients underwent laminectomy or fenestration. Invasion of the tumor on the vertebral body and involvement of more than two sections above the case, while removing the tumor, the corresponding segmental vertebral fixation fusion surgery. Results under the microscope were removed, the line of vertebroplasty fusion surgery in 3 cases. Postoperative neurological symptoms were significantly improved. Follow-up 0.5 ~ 3.5 years, an average of 2.2 years, no tumor recurrence and postoperative spinal deformity. Conclusion Internal and external spinal canal tumor is more common in the cervical segment, followed by the thoracic and lumbar segments. A total removal of the more difficult surgery, the tumor after resection of good effect. On the tumor invasion of vertebral body and involvement of more than two segments of the cases should be fixed vertebral fusion, to maintain spinal stability.