椎管内海绵状血管瘤的显微外科治疗——26例临床分析

背景与目的：随着MRI检查的普及，椎管内海绵状血管瘤的诊断变得相对简单。因椎管内海绵状血管瘤以髓内型最多见．显微外科治疗甚为关键。本研究旨在探讨椎管内海绵状血管瘤的临床特点和显微手术治疗效果。方法：2000年1月至2005年4月间北京天坛医院神经外科治疗椎管内海绵状血管瘤26例，均行MRI检查，全组均经后正中直入路显微手术治疗。结果：26例病灶均为单发，均经手术切除。其中23例全部切除，2例近全切除，1例大部切除。所有病例术后均经病理证实为海绵状血管瘤。术后神经功能状况改善20例，无变化5例．恶化变差1例。全组无手术死亡。结论：显微手术切除椎管内海绵状血管瘤是本病的首选治疗方法，全切除病灶可避免病变复发和再出血。术中精细的显微操作是手术成功的关键，术前症状轻和病灶处理及时与术后恢复良好相关。

Microsurgerical Treatment of Intraspinal Cavernous Angiomas:Report of 26 Cases

BACKGROUND & OBJECTIVE: Introspinal cavernous angiomas are not common. This artical is to discuss presentation and microsurgical management of intraspinal cavernous angiomas. METHODS: Twenty-six patients with histologically confirmed intraspinal cavernous angiomas treated at Beijing Tiantan Hospital,from January of 2000 to April of 2005,were reviewed. All the patients underwent preoperative magnetic resonance (MR) imaging and were treated with laminectomy and microsurgical resection of the malformation. RESULTS: Total removal was achieved in 23 patients,subtotal removel in 3 and partial removal in 1. The postoperative neurological status were improved in 20 patients,remained unchanged in 5,and aggravated in 1. No surgery related death occurred. CONCLUSIONS: Microsurgery is the first choice for the treatment of intramedullary cavernous angiomas. A total removal of the lesion can avoid recurrence and the repeated hemorrhage. The microneursurgical techniques are a key to the successful treatment. The postoperative functional recovery is associated with mild paraparesis and early diagnosis.