Toyama分型在颈段椎管内哑铃形肿瘤手术入路选择中的应用

目的 探讨Toyama分型在颈段椎管内哑铃形肿瘤手术入路选择中的应用效果。方法 回顾性分析2011年1月至2019年12月显微手术治疗的21例颈段椎管内哑铃形肿瘤的临床资料，依据Toyama分型计划手术入路。结果 肿瘤全切除18例，次全切除3例。术中均未发生椎动脉损伤。术后发生脑脊液漏并感染5例，行腰大池置管及抗感染治疗后痊愈；术后出现相应神经根支配区麻木感1例，自行缓解。术后随访1~3年，平均21个月；肿瘤全切除的病人无肿瘤复发；1例次全切除病人局部复发1例；21例均未发生脊柱畸形。结论 Toyama分型几乎囊括了所有颈段椎管内哑铃形肿瘤，详细描述了各亚型的影像学表现，对于手术入路的选择具有较大的指导意义。

Application of Toyama classification system in surgical approach selection of dumbbell tumors of cervical vertebrae

Objective To investigate the value of Toyama classification system in the selection of surgical approaches for cervical dumbbell tumors. Methods The clinical data of 21 patients with cervical dumbbell tumors who underwent microsurgery from January 2011 to December 2019 were analyzed retrospectively. The surgical approach was planned according to the Toyama classification system. Results Total tumor resection was performed in 18 patients and subtotal in 3. No vertebral artery injury occurred during the operation. Cerebrospinal fluid leakage and infection occurred in 5 cases who were cured after lumbar cistern catheterization and anti-infection treatment. Hemp sense in the corresponding nerve root branch area occurred in one patient who was relieved by itself. Twenty-one patients were followed up for 1~3 years with an average of 21 months. There was no tumor recurrence in the patients who underwent total tumor resection. Local recurrence of tumor occurred in 1 patient who underwent subtotal tumor resection. No spinal deformity occurred in all the patients. Conclusion Toyama classification system, which is of great significance for the choice of surgical approach of cervical dumbbell tumors, includes almost all types of cervical dumbbell tumors and describes the imaging features of each subgroup in detail