Sato M, Takemitsu Y, Iwahara T, Ozawa K, Atsuta Y, Muramoto T
Department of Orthopaedic Surgery, Asahikawa Medical College, Nishikagura, Japan.
J Spinal Disord. 1998 Aug;11(4):354-8.
Determination of the level of spinal cord tumors that develop around the foramen magnum or high cervical region can be difficult, because the symptoms of such tumors are quite variable. The surgical approach to use in such cases remains controversial. We describe here three cases of spinal cord tumor originating from the second cervical nerve root. Initial symptoms included occipital pain, glove-type numbness, and paresthesia of the upper extremities. In all three cases, myelopathic signs preceded radicular signs. It was possible to resect the tumors almost completely by using a posterior approach with microsurgical technique. Several reports have concerned the best surgical approach for high cervical spinal cord tumors. However, by using our method, tumors originating from the C2 root could be exposed without destroying the facet joints, because the nerve root runs dorsal to the lateral facet joints. We therefore recommend resecting these tumors except when they involve the vertebral artery and facet joints.
确定枕骨大孔或高位颈椎区域周围发生的脊髓肿瘤的水平可能很困难，因为此类肿瘤的症状变化很大。在此类病例中使用的手术方法仍存在争议。我们在此描述三例源自第二颈神经根的脊髓肿瘤病例。初始症状包括枕部疼痛、手套型麻木和上肢感觉异常。在所有三例病例中，脊髓病体征先于神经根体征出现。通过采用后路显微外科技术，几乎可以完全切除肿瘤。有几份报告关注高位颈椎脊髓肿瘤的最佳手术方法。然而，通过我们的方法，源自C2神经根的肿瘤可以在不破坏小关节的情况下暴露，因为神经根走行于外侧小关节的背侧。因此，我们建议切除这些肿瘤，除非它们累及椎动脉和小关节。
