椎管原发性肿瘤致截瘫临床特点与外科治疗效果分析

目的 探索椎管原发性肿瘤致截瘫原因,分析采用显微外科技术摘除肿瘤疗效。方法对23例原发性椎管肿瘤致截瘫病例进行治疗,对其致瘫的原因、临床特点、影像学改变进行分析。结果 经术后3～26个月随访,依据美国脊柱损伤学会对Frankel脊髓损伤修订分级标准评定:除2例术后截瘫无改善外,其它21例瘫痪基本恢复。结论 详细的病史收集、系统的物理检查、高质量影像检查与分析,是早期诊断的关键;避免盲目性推拿、按摩、牵引是预防突发性截瘫或截瘫加重的重要环节;显微外科技术切除肿瘤,具有解剖层次分明,肿瘤切除彻底,对脊髓、神经根干扰小的优点,其疗效更令人满意。

Analysis of clinical characteristics and therapeutic efficacy of the paraplegia caused by primary tumor in ver- tebral canal

Objective To explore the reasons of the paraplegia caused by primary tumor in vertebral canal and analyse effect of excision of tumor with microsurgical technique Methods 23 cases paraplegia caused by primary tumor in vertebral canal were treated,paraplegic reasons,clinical characteristics and image changes were analyzed. Results All cases were followed up form 3 to 26 months after operation. According to ASIA's standard, 2 cases of paraplegia were hardly improved, 21 cases were recovered very well. Conclusion Careful history taking, systematic physical examination and high quality of image determination and analysis are the keys for early diagnosis. Avoiding blind manipulation and traction is important for prevention of exacerbation of the paraplegia. Excision of tumor with microsurgical technique showed the advantage of distinct anatomic stratification,resect tumor thoroughly and lowest confusion for spinal cord and never root, the effect is satisfactory.