手术治疗68例椎管内肿瘤的疗效分析-东南大学学报医学版

手术治疗68例椎管内肿瘤的疗效分析

单位：1. 南京鼓楼医院集团宿迁市人民医院骨科, 江苏宿迁 223800;
2. 东南大学附属中大医院骨科, 江苏南京 210009

分类号：R739.42

出版年·卷·期（页码）：2016·35·第一期（67-70）

摘要：

目的:探讨后路全椎板切除入路手术治疗椎管内神经鞘瘤和脊膜瘤的临床疗效。方法:回顾性分析手术治疗68例椎管内神经鞘瘤和脊膜瘤患者的临床资料,按Frankel神经功能分级和改良Macnab疗效评定标准评价患者的临床疗效,并复查X线片观察脊柱稳定性。结果:68例患者肿瘤均完全切除,经病理确诊神经鞘瘤44例,脊膜瘤24例。术后神经功能分级:Frankel A 1例,Frankel B 0例,Frankel C 4例,Frankel D 24例,Frankel E 39例。症状改善优良率为88.2%。随访期间复查X线片未见明显脊柱不稳征象。结论:经后路全椎板切除术可以最大范围地暴露椎管内肿瘤,利于肿瘤的完全切除,配合椎弓根钉内固定技术重建脊柱稳定性,用于治疗椎管内神经鞘瘤和脊膜瘤,短期内疗效确切。

Objective:To explore the effects of the posterior laminectomy for treating spinal canal schwannoma and meningioma. Methods:The clinical data of 68 cases with spinal canal schwannoma and meningioma for surgical treatment were retrospectively analyzed. Evaluate therapeutic effect according to Frankel neural function classification and the standard of modified Macnab. Observe spinal stability by reviewing the X-ray examination. Results:The tumors of 68 cases were completely removed, including 44 cases with schwannoma and 24 cases with meningioma by pathological diagnosis. The results of postoperative neurological classification were as follows, Frankel A in 1 case, Frankel B in 0 case, Frankel C in 4 cases, Frankel D in 24 cases, Frankel E in 39 cases. The improving rate of neurological symptoms was 88.2%. No spinal instability occurred by the X-ray examination during the follow-up review. Conclusion:The posterior laminectomy can expose the spinal canal tumors completely and reconstruct spinal stability cooperating with pedicle screw internal fixation. The short-term curative effect is remarkable.

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