脊髓内表皮样囊肿的临床分析（附4例报告）

目的总结脊髓内表皮样囊肿的临床特点，探讨其手术时机、手术方式的选择。方法回顾分析2009年8月至2011年12月间收治的4例经手术和病理证实的脊髓内表皮样囊肿患者的临床资料。4例脊髓内表皮样囊肿中，3例位于胸腰段脊髓内，1例位于胸段脊髓内。结果手术采用后正中入路，在显微镜下操作，2例囊肿完全切除，2例术中残留部分囊壁。术后3例病人症状及体征均明显好转，1例病人好转不明显。术后随访1～29月，3例病人恢复正常工作，半年后复查MRI未见肿瘤复发；1例病人能自动下床活动。结论早期发现、早期诊治是脊髓内表皮样囊肿治疗成功的关键。显微手术技术的发展有助于完整切除囊肿，减少术后神经功能的废损率和囊肿的复发率。

Intramedullary spinal epidermoid cysts:a clinical analysis of 4 cases

Objective To explore the clinical features and operative opportunity, operative mode of the intramedullary spinal epidermoid cysts （IMSEC）. Methods The clinical data of 4 patients （age range, 14-15 years） with IMSEC, of whom, 1 was male and 3 female, treated by surgery from August, 2009 to December, 2011 were analyzed retrospectively. IMSEC in 1 patient was located in the thoracic spinal cord and 3 were in the thoracolumbar spinal cord （conus）. Results IMSEC were totally removed in 2 patients and there was a part of the cystic wall remnant in 2. The following up from, to 29 months showed that the symptoms were significantly improved in 3 patients and insignificantly in 1. Conclusions The early diagnosis and treatment are the key to successful treatment of IMSEC. The curative effect of early microsurgery on IMSEC is good.