Lenelle J, Born J D, Collignon J
Neurochirurgie. 1986;32(3):262-5.
The authors report a case of an intradural spinal meningioma ventrally located just rear to the 5th cervical body. The patient (a 46-year-old woman) suffered from a spasmodic quadriplegia, walking was nearly impossible. Because of the strictly median and ventral localization the authors have chosen an anterior approach passing through the body of C5 after discectomy of C4-C5 and C5-C6 discs. The tumor and its dural attachment was totally removed with respect to the spinal cord and all rootlets. Reconstruction of cervical spine was performed with an iliac bone graft. The neurological recuperation was complete and quickly achieved. Bone fusion was obtained within 3 months with a good result. The authors emphasize the rarity of ventrally located meningiomas in the cervical spine and the advantages of anterior route which alone enables a total surgical removal of such lesions.
作者报告了一例硬脊膜内脊髓脑膜瘤病例,该肿瘤位于腹侧,恰好在第5颈椎体后方。患者(一名46岁女性)患有痉挛性四肢瘫,几乎无法行走。由于肿瘤严格位于正中且在腹侧,作者选择了前路手术,在切除C4-C5和C5-C6椎间盘后,经C5椎体进入。肿瘤及其硬脑膜附着处相对于脊髓和所有神经根均被完全切除。采用髂骨移植进行颈椎重建。神经功能完全恢复且恢复迅速。3个月内实现了骨融合,效果良好。作者强调颈椎腹侧脑膜瘤罕见,以及前路手术的优势,即只有前路手术才能完全切除此类病变。