哑铃型椎管肿瘤的临床诊治分析

目的　探讨哑铃型椎管肿瘤的临床特征以及诊疗方法。方法　回顾性分析我院自１９９８至２００８年１０年间收治的２８例哑铃型椎管肿瘤患者的临床资料。结果　２８例哑铃型椎管肿瘤患者均经ＭＲＩ和术后组织病理学检查明确诊断，临床特征主要为椎管内压迫症状（根性疼痛、感觉异常、肌无力）和椎管外压迫症状（椎体周围发现包块）。所有病例均行Ⅰ期手术切除，无手术死亡，２３例获得随访，随访７个月～１０年，１８例恢复正常工作。结论　对椎管肿瘤患者应重视临床病史和体格检查；ＭＲＩ检查在哑铃型椎管内肿瘤的诊断和手术方式的选择上占重要地位；早期诊断、Ⅰ期手术完全切除肿瘤是优选有效的治疗方法。

Clinical diagnosis and treatment of dumbbell intra-extradural tumors

Objective To investigate the clinical characteristics, diagnosis and treatment of dumbbell intra-extradural tumors. Methods From January 1998 to December 2008, 28 patients with dumbbell intra-extradural tumors were studied retrospectively. Results The main clinical features of dumbbell intra-extradural tumor were intraspinal compression symptom （ including root pain, paraesthesia, myasthenia） and extraspinal compression symptom（ tumor surrounding vertebral body）. All the cases were diag- nosed by MRI and histopathology methods. Surgical excisions of I stage were performed in all patients, and no patients died during operation. Twenty-three patients got detailed follow-up, and 18 patients returned to work. Conclusion Case history, check-up and MRI examination played a vital role in diagnosis and selection of surgical management of dumbbell intra-extradural tumor. Early diagnosis and entirely removal of tumor in I stage were the best treatment for dumbbell intra-extradural tumor.