颅颈交界区肿瘤的手术治疗

目的总结颅颈交界区肿瘤的手术治疗经验，对手术入路的选择和手术技巧进行探讨。方法在对10例颅颈交界区肿瘤患者的临床及影像学资料、手术入路和技巧进行充分术前讨论的基础上，9例行肿瘤全切除，1例次全切除。其中2例采用重建钛板和颈3、颈4椎弓根镙钉固定的枕颈融合术，同时行自体髂骨植骨。结果9例存活，1例死于小脑出血并脑干功能衰竭。术后随访6～24个月，9例均有不同程度的症状改善，复查头颈部MRI，未见肿瘤复发。结论术前MRI检查对手术入路的选择具有重要价值。熟悉颅颈交界区解剖，选择合适手术入路，精细的手术技巧是手术成功的关键。

Surgical treatment of tumors in craniocervical junction

Objective To discuss the experience of surgical treatment for tumors in craniocervical junction. Methods The clinical manifestations, neuro-images, microsurgical methods and results of follow-up of 10 patients of craniocervical tumors were retrospectively analyzed. Results 9 patients was performed with total tumor excision and the other patients with subtotal resection. Two cases was treated with occipitocervical fixation of C3 and C4 pedicle screws fixation with the reconstructed plate, and autogenous iliac bone graft. 9 cases survived and 1 case died of cerebellar hemorrhage and the failure of brainstem function. During follow-up for 6 to 24 months, the symptoms of 9 cases was improved in various degrees. Conclusion MRI have great value for surgical treatment on craniocervical tumors.