Spirig J, Fournier J-Y, Hildebrandt G, Gautschi O P
Klinik für Neurochirurgie, Kantonsspital St. Gallen.
Praxis (Bern 1994). 2011 Jul 6;100(14):849-56. doi: 10.1024/1661-8157/a000592.
Intradural spinal tumors are classified in extra- and intramedullary tumors. The most frequent intradural-extramedullary tumors are meningiomas and neurinomas. Among the intradural-intramedullary tumors the most frequent ones are ependymomas and astrocytomas. Independent of their origin, spinal tumors usually manifest with progressive local or radicular pain and neurological deficits. The treatment of choice for most of these tumors is a complete surgical resection. In tumors with infiltrative growth into the intramedullary area, a marginal tumor tissue has to be left in situ in order to avoid additional neurological deficits. In particular if neurological deficits appear, a fast surgical intervention is indicated, since the prognosis depends on duration and severity of the preoperative existing deficits. Below, clinical presentation and relevant treatment options of spinal intradural tumors are discussed.
硬脊膜内脊髓肿瘤分为髓外和髓内肿瘤。最常见的硬脊膜内髓外肿瘤是脑膜瘤和神经鞘瘤。在硬脊膜内髓内肿瘤中,最常见的是室管膜瘤和星形细胞瘤。无论起源如何,脊髓肿瘤通常表现为进行性局部或神经根性疼痛以及神经功能缺损。这些肿瘤大多数的治疗选择是完整的手术切除。对于浸润生长至髓内区域的肿瘤,必须将边缘肿瘤组织留在原位,以避免额外的神经功能缺损。特别是如果出现神经功能缺损,需要进行快速手术干预,因为预后取决于术前已存在缺损的持续时间和严重程度。以下将讨论脊髓硬脊膜内肿瘤的临床表现和相关治疗选择。