Payer M, Radovanovic I, Jost G
Department of Neurosurgery, University Hospital of Geneva, 24 Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland.
J Clin Neurosci. 2006 Jul;13(6):690-3. doi: 10.1016/j.jocn.2005.09.010. Epub 2006 Jun 23.
Dumbbell tumours are those with an intraspinal and a paraspinal component, connected through a frequently enlarged and eroded intervertebral foramen. Most dumbbell tumours are located in the thoracic spine, and most of them are schwannomas. The extraspinal tumour extension is usually larger than the intraspinal tumour part, but the intraspinal tumour component commonly causes the typical symptoms: local pain and symptoms from spinal cord compression in the thoracic spine. Diagnosis is best established by magnetic resonance imaging with and without contrast agent injection. Controversy exists as to whether to remove thoracic dumbbell tumours using a single posterior approach with posterolateral extension or using a combined posterior and transthoracic approach. We report the removal of a dumbbell neurinoma at T6/7 using a single posterior midline approach with laminectomy and costo-transversectomy and review the literature regarding the approaches to thoracic dumbbell tumours.
哑铃状肿瘤是指具有椎管内和椎旁成分的肿瘤，通过常扩大和侵蚀的椎间孔相连。大多数哑铃状肿瘤位于胸椎，且大多数为神经鞘瘤。椎管外肿瘤延伸通常大于椎管内肿瘤部分，但椎管内肿瘤成分通常会引起典型症状：局部疼痛和胸椎脊髓受压症状。最佳诊断方法是注射造影剂和不注射造影剂的磁共振成像。对于采用单一后路加后外侧延伸入路还是联合后外侧和经胸入路切除胸椎哑铃状肿瘤存在争议。我们报告采用单一后正中入路行椎板切除术和肋横突切除术切除T6/7水平的哑铃状神经鞘瘤，并回顾有关胸椎哑铃状肿瘤手术入路的文献。
