椎管内脊膜瘤的临床诊断和手术治疗

目的总结椎管内脊膜瘤的临床诊断和手术治疗经验。方法回顾性分析25例椎管内脊膜瘤的临床表现、影像学特征、手术方式以及手术前后患者脊髓、神经功能改善情况。结果 25例患者肿瘤均完整切除并经病理证实,所有患者术后神经功能均有明显恢复,术后3例并发脑脊液漏,22例获得随访3个月～5年,平均2年8个月,大部分恢复正常生活,2例复发再次手术。结论 MRI检查对脊膜瘤有较高的诊断率,最终确诊依赖于病理诊断;椎管内脊膜瘤治愈率较高,临床效果好,少数有复发倾向;早期诊断、彻底切除肿瘤及熟练仔细的操作是手术成功的关键。

Clinical diagnosis and surgical treatment of intraspinal meningioma

Objective To summarize the clinical diagnosis and surgical treatment of intraspinal meningioma.Methods A retrospective study from our department was practised in 25 cases of intraspinal meningioma of clinical manifestations,imaging data,surgical approach,as well as before and after surgery in patients with spinal cord or nerve function to improve the situation.Results Tumors were completely resected in 25 cases,pathologically confirmed,and all patients had obviously the restoration of neurological function.The postoperative complication occurred in 3 cases by cerebrospinal fluid leakage.The following up period were from 3 months to 5 years in 22 patients,mean two years and eight months,most of patients had good restoration.Reoperation were performed for the tumor focus recurrence in 2 cases.Conclusion MRI examination of meningioma has a high diagnostic rate,but the final diagnosis relies on pathological diagnosis.Intraspinal meningioma has high cure rate and good clinical results,but a few trend to be recurrent.Total resection of the tumor may result in good restoration,early diagnosis,reasonable approach and operation is of the key of success.