Liu Cang, Zhang Jing, Jia Wen-qing, Hou Ru-guang, Chen Xu, Liu Yang
Department of Neurosurgery, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China.
Zhonghua Yi Xue Za Zhi. 2010 Sep 21;90(35):2495-7.
To discuss the clinical features and surgical tactics of neurogenic tumors external spinal canal.
The investigators retrospectively analyzed the clinical data of 56 cases with neurogenic tumors external spinal canal as confirmed by pathology at our department from January 2000 to June 2010. And the follow-up results were tracked. Among the patients, 51 cases underwent microsurgery and 5 cases routine retro-peritoneal operation.
Fifty cases received total resection and 5 cases subtotal resection. Partial tumor removal was performed in 1 case with multiple Schwannoma only because nerve roots were densely distributed around the tumor. Postoperative complications included declining myodynamia (n = 3), extremity pain (n = 2), topical sensory disturbance (n = 7), hoarseness (n = 5), ipsilateral facioplegia & hypophysis (n = 1) and Horner's syndrome (n = 2). Thirty-six cases had a follow-up period of 0.5 year to 10 years. No in situ recurrence was found in 34 cases. Two cases with in situ recurrence were re-operated. There was no operative death.
The surgery of neurogenic tumors external spinal canal can improve the symptoms and quality of life for the patients. A better outcome is based on anatomic familiarity and skilled micromanipulation. The key aspects of tumor resection are a maximal protection of proximal important vessels and nerves and thorough tumor dissection.
探讨椎管外神经源性肿瘤的临床特点及手术策略。
回顾性分析2000年1月至2010年6月在我科经病理确诊的56例椎管外神经源性肿瘤患者的临床资料,并对其随访结果进行跟踪。其中51例行显微手术,5例行常规腹膜后手术。
50例肿瘤全切,5例次全切。1例多发神经鞘瘤因肿瘤周围神经根密集分布仅行部分肿瘤切除。术后并发症包括肌力下降(3例)、肢体疼痛(2例)、局部感觉障碍(7例)、声音嘶哑(5例)、同侧面瘫及垂体功能减退(1例)和霍纳综合征(2例)。36例获得0.5年至10年随访。34例无原位复发。2例原位复发患者再次手术。无手术死亡。
椎管外神经源性肿瘤手术可改善患者症状及生活质量。良好的手术效果基于对解剖结构的熟悉及熟练的显微操作。肿瘤切除的关键在于最大限度保护近端重要血管和神经并彻底切除肿瘤。