手术治疗6例症状性脊柱血管瘤

目的评价360°全脊柱切除治疗症状性脊柱血管瘤的手术疗效。方法对6例胸椎血管瘤骨外生长压迫脊髓引起神经功能障碍患者,采用360°全脊柱切除、椎体重建植骨融合、后路椎弓根螺钉系统固定治疗。2例术后辅以放射治疗。结果术中失血量1 000~1 500 ml。患者术后神经压迫症状均消失,随访1~4年,未见肿瘤复发,植骨均融合,内固定未见松动、断裂。结论对胸椎椎体血管瘤合并胸脊髓压迫症患者,采用360°全脊柱切除、椎体重建植骨融合、后路椎弓根螺钉系统固定的手术方法,具有可靠、持久的疗效。

The surgical treatment of thoracic vertebral angioma with extraosseous extension causing spinal cord compression

Objective To evaluate the effect of 360° spondylectomy for thoracic angioma with extraosseous extension causing spinal cord compression and neurological dysfunction.Methods Six cases of thoracic vertebral body angioma with extraosseous extension and spinal cord compression were operated on through anterior approach to resect the involved vertebral body and intracanal angioma,and bone graft and internal fixation were also completed in one-stage.Two patients accepted radiotherapy for two period of treatment postoperatively.Results The blood loss during operation was 1 000~1 500 ml.All the patients recovered their neurological function shortly after operation.The follow-up time was 1~4 years.No patient showed recurrence of angioma.The bone graft was solidly fused in all the patients.No hardware failure occurred.Conclusions 360° spondylectomy for thoracic vertebral body and extraosseous angioma with spinal cord compression is effective,reliable and workable.Good long-term result can be obtained.