经胸联合后正中入路切除胸椎哑铃型神经源性肿瘤

目的 探讨胸椎哑铃型神经源性肿瘤的手术方法。方法 1991年3月至1999年3月经胸联合后正中入路一期切除胸椎哑神经源性肿瘤7例，其中神经纤维瘤4例，神经鞘瘤2例，恶性神经鞘瘤1例。结果 6例获肉眼下全切除，1例次全切除，所有患症状均不同程度改善。随访6例，平均3.5年，5例正常生活、工作，1例恶性神经鞘瘤3例前次全切除刚结束放射治疗，未见复发。结论 经胸联合后正中入路能满意暴露肿瘤，安全切除复杂的胸椎哑铃型神经源性肿瘤。

Resection of DumbbellNeurogenic Tumors in Thoracic Spine via Transthoracic-posteriomedial Approach

Objective To evaluate proper surgical management of dumbbell neurogenic tumors in the thoracic spine. Methods Seven patients (male 5, female 2) with thoracic dumbbell neurogenic tumors were treated between Mar 1991 and Mar 1999. The tumors included neurofibroma (4 patients), schwannoma (2) and malignant schwannoma (1). Resection of the tumor via the transthoracic-posteromedial approach was underwent in all patients. Results Gross total resection was achieved in 6 patients, subtotal in the remaining one, who suffered from a malignant schwannoma diffusely infiltrated into left thoracic cavity. Symptoms were obviously improved in all patients postoperatively. A long-term follow-up was carried out in 6 cases for a mean period of 3.5 years and showed that all of them were clinically stable and there was no evidence of recurrence. Conclusion The combined approach can provide excellent exposure for the dumbbell tumors and most of the tumor can be safely resected.