椎管内肿瘤的诊断及治疗

目的探讨椎管内肿瘤的临床特点及治疗疗法。方法回顾性的分析1999年7月～2008年6月我科经手术和病理明确诊断的67例椎管内肿瘤患者的临床症状和体征、影像学检查、病理类型、部位、手术治疗方式和疗效。结果MRI检查能对椎管内肿瘤准确定位,有41例（61．2％）做到定性诊断,有2例假阳性。63例良性肿瘤采用后路切除,内固定7例,4例转移性肿瘤采用前路切除,植骨内固定术;随访41例,随访时间9个月～8年,好转31例,复发或加重8例,死亡2例。结论M砌是诊断椎管内肿瘤最重要的手段,它能准确定位,有较高比例（61．2％）的定性诊断,因有假阳性,应密切结合临床。良性椎管内肿瘤早期诊断和手术,预后较好,转移性椎管内肿瘤的手术治疗应非常慎重。

The diagnosis and tretment of intraspinal trmor

Objective To explore the clinical characteristics and treatment of intraspinal tumor. Methods From July 1997 to June 2008,67 cases of intraspinal tumor were diagnosed by both surgery and biopsy in our department. We retrospectively analyzed the data of clinical symptoms and signs, imaging, pathological type, location, surgical treatment and efficacy. Results The intraspinal tumor could be accurately positioned by MRI. There were 41 in 67 cases（61.2% ）qualitatively diagnosed by MR/ with 2 cases of false positive. 63 cases of benign tumor were treated through posterior approach,with 7 cases of internal fixation. Anterior resection and internal fixation with bone grafting were done in 4 cases of metastatic tumor. 41 cases were followed-up for 9 months to 8 years,with 31 cases cured or improved,8 cases of recurrence or aggravation and 2 cases of death. Conclusion MR/is the most valuable way of diagnising intraspinal tumor for its accurate positioning and high rate of qualitative diagnosis （61.2%）, but there is a small incidence of false positive. The prognosis is better with early diagnosis and surgical treatment in intraspinal benign tumor eases. Surgical treatment of intraspinal metastatic tumor should be very careful.