摘要
本文旨在探讨伴脊髓压迫颈椎椎管内骨软骨瘤的临床特点、基底渐进磨除切除手术方法及疗效。本文报告2例抵至颈椎管前壁的椎管内骨软骨瘤患者的临床资料,2例患者均行基底渐进磨除切除。患者手术顺利,肿瘤均被完全切除。术后患者神经功能均有不同程度改善,无并发症发生。本文还对文献库进行了系统检索,共检出16篇文献,涉及17例患者。瘤体基底部起源椎板(包括C1后弓)13例(76.5%)、椎体后缘3例(17.6%)、小关节1例(5.9%)。瘤体整体形态有描述者13例,基底部小于瘤体最大横截面11例(84.6%),不规则形状2例(15.4%)。纳入的17例中,瘤体起源部位非椎体后缘的14例患者均采取后路手术行椎板及瘤体切除,瘤体起源于椎体后缘的3例患者中2例采取了前后路联合手术以更好地切除瘤体、保护硬膜囊及保持颈椎稳定,1例采取了前路手术。总之,基底渐进磨除切除手术是有效的治疗方法,术前准确评估、精细操作及术后严密观察是提高手术成功率、减少并发症的关键。
The objective of this study was to investigate the clinical features and surgical methods for cervical intraspinal osteochondro-ma complicated with spinal cord compression,as well as the consequence of progressive resection from the base.Firstly,two patients were reported,who underwent progressive resection from the base for cervical intraspinal osteochondroma complicated with spine cord compres-sion.The surgery was successfully operated with the tumors removed completely,and the neurological function of the patients improved to different degrees after operation,without severe complications.In addition,a systematic search on the cervical intraspinal osteochondroma was conducted in the literature database.A total of 16 papers were included,involving 7 patients.Of them,13 patients(76.5%)had the tu-mor with base on the cervical lamina,including the posterior arch of Ci,3 patients(17.6%)had the tumor with base on the posterior margin of the vertebral body,and 1(5.9%)had the tumor based on the facet.In 13 articles the overall shape of the tumor was described,with the basal part smaller than the maximum cross-section of the tumor in 11 cases(84.6%),and the irregular shape in 2 cases(15.4%).Among the 17 cases included,14 patients whose tumor originated from a location other than the posterior margin of vertebral body underwent posterior approach operation,including laminectomy and tumor resection;2 of the 3 patients whose tumor originated from the posterior margin of ver-tebral body underwent combined anterior and posterior approach surgeries to better excise the tumor,protect the dural sac and maintain cer-vical stability,and the remaining 1 patient underwent anterior surgery.In conclusion,progressive resection from the base is an effective treatment method,and accurate preoperative evaluation,fine operation and strict postoperative observation are the key to improve the suc-cess rate of surgery and reduce complications.
作者
孙静涛
胡永成
赵志辉
王永清
SUN Jing-tao;HU Yong-cheng;ZHAO Zhi-hui;WANG Yong-qing(Fourth Central Hospital of Tianjin City,Tianjin 300140,China;Tianjin Hospital,Tianjin 300211,China)
出处
《中国矫形外科杂志》
北大核心
2025年第14期1286-1294,共9页
Orthopedic Journal of China
基金
山东省医药卫生科技发展计划项目(编号:202204070193)。
关键词
颈椎椎管内骨软骨瘤
脊髓压迫
基底渐进磨除切除
cervical intraspinal osteochondroma
spinal cord compression
progressive resection from the base
作者简介
孙静涛,副主任医师,研究方向:骨关节疾病,(电子信箱)oicqoicq2000@163.com;通信作者:胡永成,(电话)022-60916412,(电子信箱)yongchenghu@126.com。
