Iwasaki Y, Hida K, Koyanagi I, Yoshimoto T, Abe H
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo.
Neurol Med Chir (Tokyo). 1999 Nov;39(12):835-9; discussion 839-40. doi: 10.2176/nmc.39.835.
A one-stage anterior approach was performed in four patients for total removal of dumbbell type neurinoma at the cervical level. In each case, the neurinoma compressed the spinal cord in the cervical canal, developed anteriorly through the intervertebral foramen, and compressed the vertebral artery. A conventional cervical anterior approach at the tumor site was performed, followed by confirmation of the tumor located outside the spinal canal. After identification of the vertebral artery, corpectomy was carried out and the extradural component of the tumor was resected. In cases with a portion of the tumor located also within the dura mater, the dura mater was opened for removal of the intradural tumor. We found the anterior approach to be effective for the total removal of some kinds of cervical dumbbell type neurinomas.
对4例患者采用一期前路入路，完整切除颈椎节段哑铃型神经鞘瘤。每例患者的神经鞘瘤均压迫颈椎管内的脊髓，经椎间孔向前发展并压迫椎动脉。在肿瘤部位采用传统的颈椎前路入路，随后确认肿瘤位于椎管外。在识别椎动脉后，进行椎体次全切除并切除肿瘤的硬膜外部分。对于部分肿瘤也位于硬脊膜内的病例，打开硬脊膜以切除硬脊膜内肿瘤。我们发现前路入路对完全切除某些类型的颈椎哑铃型神经鞘瘤有效。
