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目的探讨哑铃型脊髓肿瘤的MR分型及对外科手术的指导意义,以提高手术疗效。方法将38例哑铃型脊髓肿瘤根据其MR表现,即根据肿瘤主体及其自椎间孔向椎管外生长情况分成三种类型,并采用相应的手术方式切除。结果经后正中入路,全椎板或部分椎板切除行MR 1型肿瘤切除18例;经颈外侧、胸、腹及盆腔入路切除MR 2型肿瘤11例;两种方法联合一期或二期手术切除MR 3型肿瘤9例。其中神经鞘瘤占大多数26例(26/38)。手术肿瘤全切29例,大部切除2例,部分切除7例。手术效果优27例;良5例;差3例。死亡3例。结论MR检查可对哑铃型脊髓肿瘤能做到术前精确定位,利用MR对肿瘤的显示分型,从而选择相应手术入路,可提高全切率并增加手术安全性。熟练的显微外科技术与预后有关。
Objective To explore the MR classification of dumbbell-shaped spinal cord tumors and its guiding significance for surgical operation so as to improve the curative effect. Methods 38 cases of dumbbell spinal cord tumors according to their MR findings, that is, according to the tumor from the foramen into the spinal canal outside the growth of the situation is divided into three types, and the corresponding surgical resection. Results The posterior median approach was performed in 18 cases of MR type 1 tumors by total laminin or partial laminectomy. MR 2 tumors were resected through lateral, thoracic, abdominal and pelvic approaches in 11 cases. Two methods combined with one or two Secondary resection of MR 3 tumors in 9 cases. Schwannoma which accounted for the majority of 26 cases (26/38). Totally 29 cases underwent surgical resection, 2 cases were mostly resected, and 7 cases were partially resected. Surgical results were excellent in 27 cases, good in 5 cases and poor in 3 cases. 3 died. Conclusions MR imaging can accurately locate the dumbbell spinal cord tumor before operation. Using MR to display the tumor type, the corresponding surgical approach can be selected, which can improve the total cutting rate and increase the surgical safety. Proficiency in microsurgery and prognosis.