[1]杨志杰　王晓东　张恒柱　严正村　佘　磊　黄建楠　廖雄飞.胸腰段椎管内硬脊膜囊肿的显微手术治疗[J].中国临床神经外科杂志,2021,26(09):666-669.[doi:10.13798/j.issn.1009-153X.2021.09.004]
　YANG Zhi-jie,WANG Xiao-dong,ZHANG Heng-zhu,et al.Microsurgical treatment for patients with thoracolumbar intraspinal dural cyst[J].,2021,26(09):666-669.[doi:10.13798/j.issn.1009-153X.2021.09.004]
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胸腰段椎管内硬脊膜囊肿的显微手术治疗()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年09期
页码:
666-669
栏目:
论著
出版日期:
2021-09-25

文章信息/Info

Title:
Microsurgical treatment for patients with thoracolumbar intraspinal dural cyst
文章编号:
1009-153X（2021）09-0666-04
作者:
杨志杰　王晓东　张恒柱　严正村　佘　磊　黄建楠　廖雄飞
225000 江苏扬州，扬州大学医学院（杨志杰）；225000 江苏扬州，扬州大学临床医学院神经外科（王晓东、张恒柱、严正村、佘　磊）；116044 辽宁大连，大连医科大学（廖雄飞、黄建楠）
Author(s):
YANG Zhi-jie1;  WANG Xiao-dong2;  ZHANG Heng-zhu2;  YAN Zheng-cun2;  SHE Lei2;  HUANG Jian-nan3;  LIAO Xiong-fei3.
1. Yangzhou University Medical College, Yangzhou 225000, China; 2. Departement of Neurosurgery, Clinical Meidical College, Yangzhou University, Yangzhou 225000, China; 3. Dalian Meidcal University, Dialian 116044, China
关键词:
椎管内硬脊膜囊肿; 胸腰段椎管; 显微手术; 疗效
Keywords:
Intraspinal cyst;  Thoracolumbar intraspinal dural cyst;  Microsurgery;  Outcome
分类号:
R 739.42; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2021.09.004
文献标志码:
A
摘要:
目的 探讨胸腰段椎管内硬脊膜囊肿的手术方法及治疗效果。方法 回顾性分析2010年8月至2018年12月收治的有明确症状的11例胸腰段椎管内硬脊膜囊肿的临床资料。采取显微镜下囊肿交通口封闭术+囊肿切除术治疗。结果 腰背部疼痛10例，下肢进行性乏力9例，下肢疼痛5例，大小便无力4例；术前MRI检查证实胸腰段椎管内硬脊膜外囊性占位，平均累及（3.7±0.7）个节段。所有病例均完成囊肿交通口封闭，囊壁全切除4例，大部分切除5例，部分切除2例。术后无新发神经功能症状，腰背部及下肢疼痛症状均减轻。术后随访6个月~5年，平均2.5年；末次随访，所有病人McCormick分级提升一个等级以上，VAS评分[（2.54±1.81）分]较术前[（5.65±2.35）分]明显改善（P<0.05），腰痛ODI评分[（10.72±3.44）分]较术前[（28.52±4.35）分]明显好转（P<0.05），MRI检查证实囊肿均无复发，X线检查无脊柱失稳变形。结论 症状明显的胸腰段椎管内硬脊膜囊肿应行手术治疗，显微镜下确认并严密封闭囊肿交通口，复位椎板，治疗效果良好。
Abstract:
Objective To explore the surgical treatment methods and their outcomes for the patients with thoracolumbar intraspinal dural cyst. Methods The clinical data of 11 patients with thoracolumbar intraspinal dural cyst who underwent microsurgery from August 2010 to December 2018 were analyzed retrospectively. The surgical methods included removal of the cyst, occlusion of the cyst fistula and replacement of the lamina. Results Of these 11 patients, 10 suffered from low back pain, 9 progressive weakness of lower limbs, 5 lower limb pain, and 4 weakness of defecation. Preoperative MRI confirmed that the cysts involved in (3.7±0.7) segments of the thoracolumbar spinal canal. All the cyst fistulas were occluded, and total removal of the cysts was achieved in 4 patients, great partial in 5, and partial in 2. There was no new neurological symptom and the back pain and lower limbs pain were relieved after the operation. Postoperative follow-up ranged from 6 months to 5 years, with an average of 2.5 years. At the last follow-up, the McCormick classification of all patients was increased by more than one level, the VAS score (2.54±1.81) was significantly lower than that (5.65±2.35) before the operation (P<0.05), the ODI score (10.72 ± 3.44) was significantly lower than that(28.52±4.35) before the operation (P<0.05), MRI examination showed no recurrence, and the X-ray examination showed no spinal instability. Conclusions Microsurgery should be recommended for the patients with thoracolumbar intraspinal dural cyst who suffered from significant symptoms. Good clinical efficacy can be achieved by tightly sealing the cyst fistulas and replacing the lamina.

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相似文献/References:

[1]谢京城　王振宇　陈晓东.胸腰段椎管内硬膜外脊膜囊肿的手术治疗[J].中国临床神经外科杂志,2018,(08):513.[doi:doi:10.13798/j.issn.1009-153X.2018.08.001]
　XIE Jing-cheng,WANG Zhen-yu,CHEN Xiao-dong..Surgical treatment of intra-spinal extradural meningeal cysts in thoracolumbar spine levels[J].,2018,(09):513.[doi:doi:10.13798/j.issn.1009-153X.2018.08.001]

备注/Memo

备注/Memo:
基金项目：江苏省高层次卫生人才“六个一工程”拔尖人才科研项目（LGY2018031）；江苏省“333高层次人才”培养项目（BRA2019026）；扬州市科技局社会发展项目（YZ2019056）
通讯作者：王晓东，E-mail：dongdongdexx@163.com
更新日期/Last Update: 1900-01-01