多节段特大椎管内神经鞘瘤的手术治疗

目的 多节段特大椎管内神经鞘瘤具有肿瘤在椎管内占位节段长，病变范围广，常常发展到椎管内外或者造成严重的脊椎结构和破坏而影响脊柱的稳定性的特点。因此，手术治疗比较困难。方法 本文总结了两例多节段特大椎管内神经鞘瘤的治疗，一例采取前后联合手术入路，全部切除肿瘤。另一例采取后路手术切除肿瘤同时行脊柱内固定及植骨融合术。结果 两例患者随访半年效果优良。结论 多节段特大椎管内神经鞘瘤手术治疗中要充分做好术前准备，注意选择正确的手术入路，以达到完全切除肿瘤的目的，在切除肿瘤时应注意操作仔细防止神经损伤，同时应解决脊柱的稳定性问题。

Treament of the giant multisegmental intrathecal schwannoma

Objective:Due to the characteristics of the multisegmental large intrathecal schwannomas,of spreading over several segments in the spinal canal,and sometimes growing beyond the structure of the spinal vertebrae with destruction of the spinal structures causing unstability of the spine,surgical treatment is usually difficult Methods:Two cases of the multisegmental large intrathecal schwannomas were reported.The first cases of multisegmental schwannomas was surgically removed via combined anterior and posterior approach in one setting,and the tumor in the second case was removed via posterior approach with posterior spinal instrumentation and bone graft fusion. Results:The half a years follow up study showed excellent outcome of the surgery. Conclusion:For the multisegmental schwannoma removal,utmost care is required in surgery.Attention should be paid for avoiding nerve injury in dissecting the tumor,and the spinal stability should be reconstructed at the same time.