高颈段椎管内肿瘤的诊断与手术治疗

目的探讨高颈段椎管内肿瘤的早期诊断和手术治疗经验。方法回顾性分析39例经手术治疗的高颈段椎管内肿瘤病人的临床资料。结果本组病例髓外肿瘤占94．9％，髓内肿瘤占5．1％。肿瘤全切除率87．2％，次全切除率12．8％。病人术后上下肢运动功能、感觉功能及膀胱功能较术前均有显著改善，术后3个月、末次随访JOA评分与术前比较差异有显著性（t=7．346、6．774，P〈0．01）。结论椎管内肿瘤术前诊断应首选MRI检查。经后正中入路切除椎板减压能充分显露椎管内肿瘤，手术全切除肿瘤预后良好。

DIAGNOSIS AND SURGERY OF INTRASPINAL TUMOR OF UPPER CERVICAL SPINE

Objective To explore early diagnosis and surgery of upper-segment intraspinal tumors （USIT） of cervical spine. Methods Clinical data of 39 patients underwent surgery for USIT of cervical spine were retrospectively reviewed. Re- sults Of the patients in this study, extramedullary tumors accounted for 94.9%, and intrameduilary tumors 5.1%. Total tumor resection was 87.2%, and subtotal 12.8%. Postoperatively, the motor function and sensory function of upper and lower limbs, and bladder function were significantly improved compared with before surgery. A last follow-up three months after surgery showed the difference of JOA score between before and after surgery was significant （t=7.346,6.774;P〈0.01）. Conclusion For preopera tive diagnosis of intraspinal tumor MRI should be the first choice. A laminectomy and decompression through posterior midline ap proach can fully reveal the tumor. The prognosis is good in patients with tumor is completely removed.