32例颈髓肿瘤显微外科治疗研究

目的 探讨颈髓肿瘤的诊断、手术入路选择及手术操作技巧.方法 回顾性分析湘雅二院神经外科自2003年6月至2005年6月经手术治疗的32例颈髓肿瘤患者的临床资料.所有患者均经术前MRI确诊,经显微手术切除,术后均行MRI复查.结果 手术显微镜下全切肿瘤29例,大部分切除3例,其中2例为星形细胞瘤,1例为脂肪瘤.术后无神经功能障碍加重及死亡者.结论 MRI对颈髓肿瘤的诊断具有最重要的价值.据此可以明确肿瘤的大致类型、位置及毗邻关系.选择合适的手术入路.显微外科手术是治疗颈髓肿瘤的有效方法,熟练应用显微外科技术和手术操作技巧是治疗成功的关键因素.

Microneurosurgicai treatment of 32 cases of cervical spinal cord tumors

Objective To explore the clinical diagnosis, micronenrosurgical approach and skills of cervical spinal cord tumors. Methods Clinical data of 32 cases with cervical spinal cord tumors who had received microneurosurgery from June 2003 to June 2005 were analyzed retrospectively. All the cases were confirmed through MRI examination and then underwent micronenrosurgical resection. Postoperative MRI examination was conducted on all patients. Results Under microscope, 29 cervical spinal cord lesions were totally removed, 3 lesions were subtotally removed which consisted of 2 cases of astrocytomas and 1 case of lipoma. No clinical deterioration or surgical mortality occurred in this series. Conclusions MRI is the most valuable for the diagnosis of the cervical spinal cord tumors and it can determine the possible type, location and adjacent relationship of the tumors, which is helpful for choosing the appropriate operative approaches. Microneurosurgery is the effective treatment for cervical spinal cord tumors. Skilled microneurosurgical techniques are the keys of success in the treatment.