Ha Y S, Yamashita J, Aoyama I, Ishikawa M, Handa H
No Shinkei Geka. 1982 Jul;10(7):709-16.
Twenty-two spinal neurinomas, admitted to the Department of Neurosurgery, Kyoto University Medical School during the past 40 years, were retrospectively analysed under the circumstances that most of lower spinal and or spinal cord tumors had usually been handled by orthopedic surgeons in Japan. Of the total of 22 cases, there were 14 cervical, 6 thoracic and 2 lumbar neurinomas. Age distribution was from 16 to 70 years of age with the average 38. Von Recklinghausen's disease accompanied spinal neurinoma in 4 cases. Of 3 cases under the age of 20, two were associated with von Recklinghausen's disease. Motor deficits were the prominent clinical symptoms on admission in 63% of the cases, while pains were the initial symptoms in 77% of the cases. Twenty-nine percent of cervical neurinomas were of dumbbell type, extending both in the intraspinal and extraspinal spaces. In addition to the conventional neuroradiologic investigations, CT metrizamide myelography was extremely advantageous in detecting the localization and relation of spinal neurinomas to the spine and spinal cord as well as bony changes. Laser surgery was utilized in the recent two cases of spinal neurinomas of dumbbell type. It was found useful in that it enabled intraspinal decompression by a non-touch technique prior to laminectomy.
回顾性分析了京都大学医学院神经外科在过去40年收治的22例脊髓神经鞘瘤。在日本，大多数下脊髓和/或脊髓肿瘤通常由骨科医生处理。22例患者中，有14例为颈段神经鞘瘤，6例为胸段神经鞘瘤，2例为腰段神经鞘瘤。年龄分布在16岁至70岁之间，平均年龄为38岁。4例神经鞘瘤患者伴有冯雷克林霍增氏病。在3例20岁以下的患者中，2例与冯雷克林霍增氏病有关。63%的患者入院时主要临床症状为运动功能障碍，而77%的患者最初症状为疼痛。29%的颈段神经鞘瘤为哑铃型，向椎管内和椎管外延伸。除了传统的神经放射学检查外，CT甲泛葡胺脊髓造影在检测脊髓神经鞘瘤的定位及其与脊柱、脊髓的关系以及骨质改变方面极具优势。最近2例哑铃型脊髓神经鞘瘤采用了激光手术。结果发现该手术很有用，因为它能够在椎板切除术之前通过非接触技术进行椎管内减压。
