胸腰段椎管内肿瘤的诊断及手术治疗

目的 探讨胸腰段椎管内肿瘤的诊断及手术要点。方法 回顾性分析经手术及病理证实的7例胸腰段推管内肿瘤临床资料。7例均行MRI检查，示椎管内占位性病变。完全切除6例。大部切除1例。结果 7例得以随诊。时间12吨1个月。症状明显改善5例。脊髓功能评分提高11-20分；1例症状稳定：1例肿瘤复发术后脊髓功能改善不良。结论 临床表现及MRI所见为诊断主要依据。诊断一旦确立。应尽早手术。术中准确定位、减少对脊髓的牵拉、挤压为手术关键。

Diagnosis and surgical treatment of tumor of thoracolumbar spinal canal

Objective] To evaluate the diagnosis and the operative procedure of the tumor of the thoracolumbar spinal canal. Methods] 7 cases of the tumor o f the thoracolumbar spinal canal confirmed operatively and pathologically were r eviewed. All patients were MRI-scanned, showing thoracolumbar spinal canal space occupying lesions. Its complete surgical removal was achieved in 6 patients, pa rtial removal in 1. Results] Seven patients were followed up from 12~81 month s. Symptoms in 5 patients whose spinal function scores had been increased by 11 to 20 were obviously improved. Symptoms were stable in 1 case, worsened again af ter postoperative relief in 1. Conclusions] The specific clinical and MRI fin dings are the principal evidence for the diagnosis of the tumor of the thoracolu mbar spinal canal. When the diagnosis is established, early surgery is recommene d. The key point of successful removal includings correctly indentification of t he vertebra level and less disturbance of spinal cord.