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髓外硬脊膜内脊髓肿瘤:现代诊断和治疗选择的综述及系列报告

Extramedullary intradural spinal tumors: a review of modern diagnostic and treatment options and a report of a series.

机构信息

Semmes-Murphey Clinic and Department of Neurosurgery, University of Tennesse, Memphis, TN, USA.

出版信息

Bosn J Basic Med Sci. 2009 Oct;9 Suppl 1(Suppl 1):S40-S45. doi: 10.17305/bjbms.2009.2755.

Abstract

Extramedullary intradural spinal tumors are rare. Less than 15% of all central nervous system (CNS) tumors are spinal. Ninety percent of these patients are older than 20 years. Most of spinal tumors are extradural (50-55%) whereas 40-45% are intradural. Furthermore, 5% are intramedullary and 40% are extramedullary. Most common are Schwannomas (29%), followed by meningiomas (25%) and gliomas (22%). These tumors produce pain syndromes, a variety of neurological symptoms- motor, sensory, sphincter or a combination of thereof. All spinal levels may be involved. The diagnostics includes magnetic resonance imaging (MRI) including contrast enhancement, computerizing tomography (CT) scanning (bone windows with reconstruction) and possibly CT myelograms. Preferred treatment is the microsurgical radical resection. Perioperative mortality is very low as is serious morbidity.We herein discuss various aspects of presenting symptomatology, diagnostics, preoperative planning and tactics, surgical treatment and complications. In addition, we include our own retrospective experience with 14 patients treated over the 5.5 years time interval.

摘要

椎管内髓外脊髓肿瘤较为罕见。中枢神经系统 (CNS) 肿瘤中不足 15%为脊髓肿瘤。90%的患者年龄大于 20 岁。大多数脊髓肿瘤为硬脊膜外(50-55%),40-45%为硬脊膜内。此外,5%为脊髓内,40%为硬脊膜外。最常见的是神经鞘瘤(29%),其次是脑膜瘤(25%)和神经胶质瘤(22%)。这些肿瘤可引起疼痛综合征,多种神经症状-运动、感觉、括约肌或组合。所有脊髓水平均可受累。诊断包括磁共振成像(MRI),包括增强扫描、计算机断层扫描(CT)(骨窗重建),可能还包括 CT 脊髓造影。首选的治疗方法是显微根治性切除术。围手术期死亡率和严重发病率均很低。我们在此讨论了临床表现、诊断、术前计划和策略、手术治疗和并发症等方面。此外,我们还包括我们在 5.5 年时间间隔内治疗的 14 名患者的回顾性经验。

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