Yin Huabin, Zhang Dan, Wu Zhipeng, Zhou Wang, Xiao Jianru
Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
World J Surg Oncol. 2014 Mar 4;12:50. doi: 10.1186/1477-7819-12-50.
This was a retrospective study.
The aim of this study was to analyze the clinical characteristics and discuss the treatment options for epidermoid cysts in the lumbar spine.
Epidermoid cysts are rare benign neoplasms, which account for less than 1% of all intraspinal tumors. Due to their rarity, there are only a few case reports in the literature. Complete excision is the recommended treatment for an epidermoid cyst, but this is difficult to achieve in the spine. In spite of their benign nature, local recurrence is not uncommon for spinal epidermoid cysts after incomplete excision.
Six patients with an epidermoid cyst in the lumbar spine underwent surgical treatment in our center between 2004 and 2011. A total excision using microsurgical techniques and reconstruction was successfully undertaken in all patients. Clinical data and detailed pathologic results were retrospectively analyzed. All cases were followed up for a median time of more than 4 years. The clinical data and surgical efficacy were analyzed to suggest treatment options for epidermoid cysts in the lumbar spine on the basis of a literature review and our own experience.
The mean age of the patients in this study was 37.7 years and the mean duration of pre-operative symptoms was 29.7 months (2 to 120 months). All patients were disease-free during their follow-up period. Radicular pain nearly disappeared, and patients suffering from neurologic deficits and defecation disorders recovered well.
Although an epidermoid cyst is a benign tumor, it is apt to recur locally following inadequate removal. Therefore, complete excision with preservation of neural function is an ideal protocol for intraspinal epidermoid cysts. Microsurgical techniques are very useful.
这是一项回顾性研究。
本研究旨在分析腰椎表皮样囊肿的临床特征并探讨其治疗方案。
表皮样囊肿是罕见的良性肿瘤，占所有椎管内肿瘤的比例不到1%。由于其罕见性，文献中仅有少数病例报告。推荐对表皮样囊肿进行完整切除，但在脊柱中难以实现。尽管其性质为良性，但脊柱表皮样囊肿在切除不完整后局部复发并不少见。
2004年至2011年间，6例腰椎表皮样囊肿患者在本中心接受了手术治疗。所有患者均成功采用显微外科技术进行了全切除及重建。对临床资料和详细病理结果进行回顾性分析。所有病例的中位随访时间超过4年。在文献回顾和我们自身经验的基础上，分析临床资料和手术疗效，以提出腰椎表皮样囊肿的治疗方案。
本研究中患者的平均年龄为37.7岁，术前症状的平均持续时间为29.7个月（2至120个月）。所有患者在随访期间均无疾病复发。神经根性疼痛几乎消失，患有神经功能缺损和排便障碍的患者恢复良好。
尽管表皮样囊肿是良性肿瘤，但切除不充分时易局部复发。因此，保留神经功能的完整切除是椎管内表皮样囊肿的理想治疗方案。显微外科技术非常有用。
