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[目的]探讨椎管髓外跨硬脊膜(硬膜内椎间孔内外)肿瘤的诊断及手术治疗方法。[方法]回顾性分析9例椎管髓外跨硬脊膜肿瘤的手术方式和治疗效果,全部病例均采用一期手术治疗,对不同部位和不同生长特性的肿瘤采用不同的手术入路和方式,应尽量将肿瘤完全切除。[结果]9例手术肿瘤均已全切,术后9例随访6～72个月,平均30.1个月,神经功能症状均明显改善,只有1例出现感觉减退,未见硬膜外与皮下脑脊液漏及囊肿形成。肿瘤均无复发及术后脊柱畸形。[结论]椎管髓外跨硬脊膜(硬膜内椎间孔内外)肿瘤的诊断和治疗具有其特殊性,须根据肿瘤部位、生长方式、大小决定手术方式,能否一期完全切除肿瘤,减少并发症是提高疗效的关键。对肿瘤侵犯椎体和受累超过2个节段及以上造成脊柱不稳的病例应行椎体固定融合术。
[Objective] To investigate the diagnosis and surgical treatment of spinal extramedullary spinal dura (intradural foramen inside and outside) tumors. [Methods] Nine cases of extradural extramedullary spinal dura tumor were retrospectively analyzed. All the cases were treated by one-stage operation. Different surgical approaches and modes were adopted for tumors with different sites and different growth characteristics , The tumor should be completely resected. [Result] Nine cases of surgical tumors had been completely resected. Nine cases were followed up for 6 to 72 months (average 30.1 months), neurological symptoms were significantly improved, and only one case had sensory loss. No epidural and subcutaneous cerebrospinal fluid Leakage and cyst formation. No tumor recurrence and postoperative spinal deformity. [Conclusion] The diagnosis and treatment of spinal extramedullary spinal dura mater (intradural foramen inside and outside) have their particularity. According to the tumor site, growth mode and size, it is necessary to determine the operation mode and whether the tumor can be completely removed in one stage To reduce the complications is to improve the efficacy of the key. The tumor invasion of the vertebral body and involvement of more than two segments and more cases of spinal instability caused by vertebral fixation should be fusion.