Gezen F, Kahraman S, Canakci Z, Bedük A
Department of Neurosurgery, Gülhane Medical Faculty, Ankara, Turkey.
Spine (Phila Pa 1976). 2000 Mar 15;25(6):727-31. doi: 10.1097/00007632-200003150-00013.
Thirty-six consecutive patients with histologically confirmed spinal cord meningioma were presented to evaluate clinical, diagnostic, therapeutic options and to correlate treatment methods and outcome.
To present the incidence, clinical presentation, localization, techniques, and long term results of surgically treated spinal meningiomas.
Meningiomas are common tumors of spinal neoplasm. They are generally benign and slow-growing. Advanced in radiologic and surgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. However, spinal meningiomas may recur, especially as a result of incomplete resection.
Thirty-six consecutive patients with histologically confirmed spinal meningiomas were treated from 1980 to 1997. Neuroradiological diagnosis was made through myelogram in 20 patients, CT scan in 15 patients, and MRI in 16 patients. All patients were operated on via the posterior approach and using microsurgical technique and when necessary Cooper-Ultrasonic surgical aspirator (CUSA) and CO2 laser were also applied. The patients were followed for 2 to 15 years (mean 9 years). Radiotherapy was not undertaken except in recurrent tumors.
The most frequent site of spinal meningiomas was in the thoracic region. In 30 (83%) patients tumors were found to be completely intradural extramedullary during surgery. Total tumor resection was achieved in 35 (97%) of patients. In the follow-up period, 30 cases (83%) improved when compared to their preoperative conditions. There was one operative mortality (3%). A 66-year-old women died of pulmonary emboli.
Magnetic resonance imaging is the best imaging technique for diagnosis. Total tumor resection improved the surgical results of spinal meningiomas. If total removal of the tumor cannot be achieved, or in the case of early recurrence followed by total resection, radiotherapy should be performed in adjuvant therapy.
对36例经组织学确诊的脊髓脑膜瘤患者进行连续观察，以评估临床情况、诊断方法、治疗选择，并关联治疗方法与结果。
阐述手术治疗脊髓脑膜瘤的发病率、临床表现、肿瘤定位、手术技术及长期疗效。
脑膜瘤是脊髓肿瘤中常见的肿瘤。它们通常为良性且生长缓慢。放射学和手术技术的进步带来了更好的手术效果。手术治疗的目标若可能应是全切肿瘤。然而，脊髓脑膜瘤可能复发，尤其是因切除不完全所致。
1980年至1997年对36例经组织学确诊的脊髓脑膜瘤患者进行治疗。20例患者通过脊髓造影进行神经放射学诊断，15例通过CT扫描，16例通过MRI。所有患者均采用后路手术，运用显微外科技术，必要时还应用了库珀超声手术吸引器（CUSA）和二氧化碳激光。对患者随访2至15年（平均9年）。除复发性肿瘤外未进行放疗。
脊髓脑膜瘤最常见的部位是胸段。30例（83%）患者术中发现肿瘤完全位于硬膜内髓外。35例（97%）患者实现了肿瘤全切。在随访期间，30例（83%）患者较术前状况有所改善。有1例手术死亡（3%）。一名66岁女性死于肺栓塞。
磁共振成像（MRI）是最佳的诊断成像技术。肿瘤全切改善了脊髓脑膜瘤的手术效果。若无法实现肿瘤全切，或在早期复发后进行全切的情况下，应在辅助治疗中进行放疗。
