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目的探讨脊髓髓内室管膜瘤的诊断、手术要点及注意事项。方法回顾分析经手术及病理证实的16例髓内室管膜瘤临床资料。男9例,女7例;年龄21～60岁,平均33.5岁。首发症状主要为受累肢体麻木无力和(或)感觉异常,随病程由上向下发展为其特征。13例行MR检查,示髓内占位性病变。完全切除11例,大部切除3例,减压活检2例。结果12例得以随诊,时间为8个月～5年8个月,症状明显改善7例,其中脊髓功能评分提高11～20分4例,10分以下3例;症状稳定3例;术后症状缓解再加重2例。结论特有临床表现及影像学所见为诊断主要依据,因其在髓内膨胀生长,多与脊髓界限清楚,掌握手术要点即可完全切除,诊断一旦确立,根据MRI所见,应尽早手术。术中探查其与脊髓界限是否清楚为手术关键。
Objective To investigate the diagnosis, surgical essentials and precautions of spinal cord myeloma. Methods The clinical data of 16 cases with intramedullary ependymoma confirmed by operation and pathology were retrospectively analyzed. 9 males and 7 females; aged 21 to 60 years old, with an average of 33.5 years old. The first symptom is mainly involved limb numbness and / or sensory abnormalities, with the disease from top to bottom for the development of its characteristics. 13 cases of MR examination showed intramedullary space lesions. Complete resection in 11 cases, most resection in 3 cases, decompression biopsy in 2 cases. Results 12 cases were followed up for 8 months to 5 years and 8 months. The symptoms improved significantly in 7 cases. The spinal cord function score increased by 11 to 20 points in 4 cases and 10 points or less in 3 cases. The symptoms were stable in 3 cases. Symptoms and then aggravate two cases. Conclusions The unique clinical manifestations and imaging findings as the main basis for diagnosis, because of its expansion in the intramedullary expansion, and more clearly bound to the spinal cord, the main points of surgery can be completely removed, once established, according to MRI, surgery should be as soon as possible. Intraoperative exploration of its boundaries with the spinal cord is the key to surgery.