Takamura Y, Uede T, Igarashi K, Tatewaki K, Morimoto S
Department of Neurosurgery, Kushiro City General Hospital, Hokkaido.
Neurol Med Chir (Tokyo). 1997 Apr;37(4):354-7. doi: 10.2176/nmc.37.354.
A 56-year-old male was admitted in January 1994, with back pain persisting for 2 months. Magnetic resonance imaging disclosed a homogeneously enhanced mass occupying the spinal canal at the T-8 level and extending into the retropleural space through the left intervertebral foramen between T-8 and T-9. The diagnosis was a thoracic dumbbell-shaped neurinoma. The tumor was successfully removed through a posterolateral approach using hemilaminectomy and partial costotransversectomy with preservation of ipsilateral joint facets. Histological examination indicated neurinoma. This approach allows excellent visualization of anterior paraspinal components of the tumor, preserves important anatomic structures, and requires minimal compression of the cord for removal of the lesion.
一名56岁男性于1994年1月入院，背痛持续2个月。磁共振成像显示T-8水平椎管内有一均匀强化肿块，并通过T-8和T-9之间的左侧椎间孔延伸至胸膜后间隙。诊断为胸段哑铃形神经鞘瘤。通过后外侧入路，采用半椎板切除术和部分肋骨横突切除术，保留同侧关节突，成功切除肿瘤。组织学检查显示为神经鞘瘤。该入路能很好地显露肿瘤的椎旁前部成分，保留重要解剖结构，且切除病变时对脊髓的压迫最小。
