[1]谢京城　王振宇　刘　彬　陈晓东.椎管内圆锥马尾区畸胎瘤的治疗[J].中国临床神经外科杂志,2018,(07):455-457462.[doi:10.13798/j.issn.1009-153X.2018.07.003]
　XIE Jing-cheng,WANG Zhen-yu,LIU Bin,et al.Surgical treatment of spinal cord teratomas in the regions of spinal conus and cauda equina (report of 51 cases)[J].,2018,(07):455-457462.[doi:10.13798/j.issn.1009-153X.2018.07.003]
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椎管内圆锥马尾区畸胎瘤的治疗()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2018年07期
页码:
455-457462
栏目:
论著
出版日期:
2018-07-25

文章信息/Info

Title:
Surgical treatment of spinal cord teratomas in the regions of spinal conus and cauda equina (report of 51 cases)
文章编号:
1009-153X（2018）07-0455-03
作者:
谢京城　王振宇　刘　彬　陈晓东
作者单位：100191 北京，北京大学第三医院神经外科
Author(s):
XIE Jing-cheng;  WANG Zhen-yu;  LIU Bin;  CHEN Xiao-dong.
Department of Neurosurgery, Third Hospital, Peking University, Beijing 100191, China
关键词:
脊髓肿瘤; 畸胎瘤; 圆锥; 马尾; 显微手术
Keywords:
Intraspinal teratoma;  Microsurgery;  Clinical features;  Curative effects
分类号:
R 739.42; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2018.07.003
文献标志码:
A
摘要:
目的 总结椎管内圆锥马尾区畸胎瘤的临床特点和治疗经验。方法 回顾性分析1997年8月至2017年7月手术治疗的51例椎管内圆锥马尾区畸胎瘤的临床资料。结果 肿瘤的囊性部分全切除46例，次全切除加囊壁电灼5例；肿瘤实性部分全切除5例，次全切除20例，大部切除26例。51例术后病理检查均为成熟性囊性畸胎瘤。术后发生脑脊液漏3例、泌尿系感染5例，均治愈。32例疼痛中，24例术后疼痛缓解或消失，8例无变化。12例运动障碍中，7例术后肌力提高1~3级，4例无变化，1例肌力下降。7例括约肌功能障碍中，4例改善，3例无变化。51例术后随访6个月~19年，平均7.8年，随访超过5年27例。按McCormick分级标准，脊髓功能好转39例，不变11例，恶化1例。随访期间，未见肿瘤复发。结论 椎管内畸胎瘤多分布于脊髓圆锥马尾区，以慢性脊髓及神经压迫为表现。手术应在显微镜下，尽量全切肿瘤的囊性部分，如有囊壁残留应电灼防止复发，对肿瘤的实性部分应在避免脊髓损伤情况下，尽量切除减压，手术疗效满意。
Abstract:
Objective To summarize the clinical features of teratomas in the regions of spinal conus and cauda equina and experience in treating them. Method The clinical data of 51 patients with intra-spinal teratomas in the regions of spinal conus and cauda equina, who were treated by surgery from August, 1997 to July, 2017, were analyzed retrospectively. Results Of 51 patients with teratomas in the regions of spinal conus and cauda equina, 46 received gross total resection of cystic component and 5 subtotal resection. The histopathological examination showed that the mature cystic teratomas were proved in all the patients, who were followed-up from 6 months to 19 years (mean, 7.8 years). The spinal neurological function evaluated by McCormick grading scale was improved in 27 patients, unchanged in 23 and deteriorated in 1 during the following-up. The teratomas did not recur in all the patients. Conclusions The intra-spinal teratomas are mostly in the conus of spinal cord. Chronic pain and neurological fect are the main clinical manifestations. The key to the surgical treatment is total resection of the cystic component under the microscope as possible. The outcomes of surgical treatment are satisfactory in the patients with intraspinal teratomas in the regions of spinal conus and cauda equina.

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更新日期/Last Update: 2018-07-25