椎管内硬脊膜外海绵状血管瘤的诊治

目的总结单纯椎管内硬脊膜外海绵状血管瘤的诊治经验。方法回顾性分析2006年2月至2009年3月经病理证实的7例单纯椎管内硬脊膜外海绵状血管瘤患者的临床表现、MRI特征和手术结果。结果 7例均表现为慢性双下肢麻木及无力,1例伴有神经根性症状;脊柱MRI显示6例病变位于胸椎,1例位于颈胸交界区;所有病变均达到手术全切,术后所有患者神经功能症状明显改善。结论单纯椎管内硬脊膜外海绵状血管瘤临床少见;主要表现为脊髓及神经根慢性受压而出现神经功能缺损症状及体征;脊柱MRI示病变位于硬脊膜外脊髓背侧或一侧,且有经相应椎间孔向外生长的趋势;手术切除病变较为容易,术后患者神经功能改善明显。

Diagnosis and treatment of spinal epidural cavernous hemangiomas

Objective To investigate the diagnosis and surgical treatment of the pure spinal epidural cavernous hemangioma. Methods The clinical data of 7 patients with pure spinal epidural cavernous hemangiomas,who underwent surgery from February,2006 to March 2009,were analyzed retrospectively.Results The clinical manifestations included progressive weakness and numbness of bilateral lower limbs in all the patients and radicular symptom in 1 patient.Spinal MRI showed that the lesions in 6 patients were in the spinal thoracic segment and the lesion in 1 patient was in cervicothoracic junction.The spinal epidural cavernous hemangiomas were totally resected and the neurological function was improved postoperatively in all the patients.Conclusions The pure spinal epidural cavernous hemangiomas are uncommon.The common symptoms and signs are neurological deficits caused by the compression of the spinal cord and nerve roots by the hemangiomas.The lesion locates in the epidural space of back or on one side of spinal cord and the its growth tends to outside through the adjacent interveterbral foramen.The neurological functions may be improved significantly after the surgery,which may be performed without difficulty.