【摘要】 目的 探讨椎管内肿瘤的手术治疗方法及手术效果。方法 对1999～2005年在我院接受手术治疗的40例椎管内肿瘤患者的病例资料进行分析。其中男20例，女20例，年龄14～64岁，平均38.8岁。采取全椎板切除肿瘤摘除术20例，腰椎半椎板切除肿瘤摘除术5例，腰椎全椎板截骨肿瘤摘除椎板再植术2例，椎板扩大切除肿瘤摘除椎弓根钉棒系统内固定术5例，颈椎椎板扩大切除肿瘤摘除侧块钢板内固定术7例，后路环脊髓减压椎弓根钉棒系统内固定术1例。结果 术后随访3个月～4年，平均14个月。术后随访期间死亡1例，复发2例，其余患者无复发。1例患者术后Frankel脊髓损伤分级评分较术前下降，无改变13例，好转27例。结论 对于椎管内肿瘤，椎板切除肿瘤摘除术是行之有效的方法，术前脊髓损伤重(Frankel脊髓损伤分级评分C以下)者神经功能恢复较差，脊髓损伤轻者神经功能恢复较好。对于肿瘤较大或者肿瘤偏于脊髓一侧者，需两侧或者单侧关节突切除者应给予钉棒系统或侧块钢板内固定，重建脊柱稳定性。

    【关键词】 肿瘤；椎管内；手术

    Surgical treatment of intraspinal tumor

    YANG Zhi-ping,LI Jian-min,LI En-hui,et al.

    Department of Orthopedics,Qilu Hospital,Shandong University,Jinan 250012,China

    【Abstract】 Objective To study the outcome of surgical treatment of intraspinal tumor.Methods The surgical results of 40 cases of intraspinal tumor and space occupying lesions during the periods from 1999 to 2005 were analyzed.Gender:male 20 cases,female 20 cases.Age:14～64 years old,average 38.8 years old.Surgery:laminectomy and tumor resection in 20 cases,lumbar semi-laminectomy and tumor resection in 5 cases.Lumbar laminotomy and replantation and tumor resection 2 cases,tumor resection and internal fixation with pedicle screw in 5 cases,tumor resection with internal fixation at cervical lateral mass in 7 cases,circumferential decompression of spinal cord and internal fixation with pedical screws in 1 case.Results All cases were followed-up from 4 months to 4 years (average 14 months).1 case died,2 cases relapsed.Frankel score decreased in 1 case, no change in 13 cases,improved in 27 cases.Conclusion For the intraspinal tumor,laminectomy and tumor resection was the effective treatment,the poorer the preoperative spinal cord function,the fewer the improvements.If the tumor is too large or locates at one side of the cord,resections of one or both sides of articular processes and internal fixations may be necessary. ......