Nagoshi Narihito, Ishii Ken, Kameyama Kaori, Tsuji Osahiko, Okada Eijiro, Fujita Nobuyuki, Yagi Mitsuru, Matsumoto Morio, Nakamura Masaya, Watanabe Kota
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Spine and Spinal Cord Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
Spine Surg Relat Res. 2018 Apr 27;2(4):331-334. doi: 10.22603/ssrr.2017-0088. eCollection 2018 Oct 26.
Intramedullary lesions and tumors are generally accessed by a posterior approach. However, if the lesion is located on the ventral side of the spinal cord, a posterior resection with myelotomy poses technical difficulties. We report two cases of complete resection of a cervical ventral intramedullary cavernous hemangioma using an anterior approach.
Two cases of intramedullary cavernous hemangioma located on the ventral side of the spinal cord were successfully treated by total resection with anterior cervical corpectomy followed by anterior spinal fusion with an autologous bone strut from the iliac crest. In both cases, the postoperative course was uneventful, and there was no neurological deficit. Bony fusion was achieved, and there was no recurrence or complication during a follow-up period of at least two years.
Here, we describe an anterior approach for total resection of cavernous hemangiomas on the ventral side of the cervical spinal cord. Outcomes were stable two years after the operations. Although the method should be assessed with more patients and a longer follow-up time, this anterior approach may be useful for the radical resection of a vascular malformation or tumor.
髓内病变和肿瘤一般通过后路进行处理。然而，如果病变位于脊髓腹侧，采用后路切开脊髓进行切除会面临技术难题。我们报告两例采用前路手术完整切除颈髓腹侧髓内海绵状血管瘤的病例。
两例位于脊髓腹侧的髓内海绵状血管瘤患者，通过颈椎椎体次全切除并取自体髂骨植骨行前路脊柱融合术成功实现了肿瘤全切。两例患者术后恢复顺利，均无神经功能缺损。实现了骨融合，在至少两年的随访期内无复发及并发症。
在此，我们描述了一种用于完整切除颈髓腹侧海绵状血管瘤的前路手术方法。术后两年结果稳定。尽管该方法需要更多患者及更长随访时间的评估，但这种前路手术方法可能对血管畸形或肿瘤的根治性切除有用。
