Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W Thomas Road, Phoenix, AZ 85013, USA.
Neurosurgery. 2011 Jun;68(2 Suppl Operative):317-24; discussion 324. doi: 10.1227/NEU.0b013e3182138d6c.
Resection of intramedullary spinal cord cavernous malformations is associated with a significant risk of morbidity because of the high density of eloquent tissue within the spinal cord. Despite this risk, surgery remains the definitive treatment for symptomatic lesions.
To review the clinical aspects of surgical approaches for spinal cord cavernous malformations.
This article reviews the epidemiology, pathophysiology, clinical and imaging characteristics, and indications for surgical resection. Surgical issues and operative approaches by anatomical location are also detailed, drawing from evidence in the literature and from the senior author's clinical experience.
The 3 primary approaches to spinal cord cavernous malformations-the posterior, posterolateral, and lateral approaches-are described and illustrated. Magnetic resonance imaging and intraoperative photographs of representative cases are included.
Intramedullary spinal cord cavernous malformations are complex entities, and it is our hope that this article will improve readers' understanding of their clinical characteristics, their indications for treatment, and the surgical pathways through which these lesions can be safely resected.
由于脊髓内有高密度的语言组织，因此切除脊髓海绵状血管畸形会带来很大的发病风险。尽管存在这种风险，但手术仍然是治疗有症状病变的明确方法。
回顾脊髓海绵状血管畸形的手术治疗方法的临床方面。
本文综述了流行病学、病理生理学、临床和影像学特征以及手术切除的适应证。还详细讨论了手术相关问题和按解剖部位的手术入路，这部分内容取材于文献中的证据和资深作者的临床经验。
描述并图示了脊髓海绵状血管畸形的 3 种主要手术入路——后路、后外侧路和外侧路。还包括了有代表性病例的磁共振成像和术中照片。
脊髓内海绵状血管畸形是复杂的病变，我们希望本文能够增进读者对其临床特征、治疗适应证以及安全切除这些病变的手术途径的理解。
