| 脊柱节细胞神经瘤的临床特点与手术治疗 |
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投稿时间：2015-08-07
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| 作者 | Author | 单位 | Address | E-Mail |
| 黄勇 |
HUANG Yong |
吉林大学第一医院脊柱外科, 吉林 长春 130021 |
Department of Spinal Surgery, the First Hospital of Jilin University, Changchun 130021, Jilin, China |
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| 吕振山 |
LYU Zhen-shan |
吉林大学第一医院脊柱外科, 吉林 长春 130021 |
Department of Spinal Surgery, the First Hospital of Jilin University, Changchun 130021, Jilin, China |
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| 刘理迪 |
LIU Li-di |
吉林大学第一医院脊柱外科, 吉林 长春 130021 |
Department of Spinal Surgery, the First Hospital of Jilin University, Changchun 130021, Jilin, China |
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| 吴迪 |
WU Di |
吉林大学第一医院脊柱外科, 吉林 长春 130021 |
Department of Spinal Surgery, the First Hospital of Jilin University, Changchun 130021, Jilin, China |
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| 李乔 |
LI Qiao |
吉林大学第一医院脊柱外科, 吉林 长春 130021 |
Department of Spinal Surgery, the First Hospital of Jilin University, Changchun 130021, Jilin, China |
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| 张绍昆 |
ZHANG Shao-kun |
吉林大学第一医院脊柱外科, 吉林 长春 130021 |
Department of Spinal Surgery, the First Hospital of Jilin University, Changchun 130021, Jilin, China |
18186872235@163.com |
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| 期刊信息：《中国骨伤》2015年，第28卷，第11期，第1013-1016页 |
| DOI：10.3969/j.issn.1003-0034.2015.11.008 |
| 基金项目: |
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中文摘要:
目的:总结脊柱节细胞神经瘤的临床表现及诊断,探讨其手术治疗效果。
方法:对2008年1月至2015年1月行手术治疗的6例脊柱节细胞神经瘤患者进行回顾性分析,男4例,女2例;年龄2～63岁,平均34.6岁;病程3 d～17年。5例患者有与肿瘤所在水平相关的浅感觉减退,肿瘤平面以下不同程度的肌力减退(肌力Ⅱ-Ⅳ级);2例肌张力增高,双侧Hoffmann征、Babinski征阳性;5例为相应节段椎管内单发病灶,1例合并胸腔内巨大占位性病变。
结果:6例患者中5例肿瘤全切除,1例行次全切除。术后病理检查可见肿瘤性节细胞散在或成束穿插于Schwann细胞间质中。术前2例神经根痛患者,术后1例症状缓解或消失,1例无变化。术前4例上下肢运动障碍者,术后均改善。随访时间0.3～6.8年,平均2.5年。末次随访时脊髓功能状态按ASIA分级标准评价,5例好转,1例不变。1例次全切除患者因合并节细胞神经母细胞瘤,术后行放化疗,另5例无复发。
结论:脊柱节细胞神经瘤较罕见,肿瘤本身为良性,临床上以根性疼痛及感觉运动障碍为主要表现;其诊断主要依靠术后病理检查确诊。手术全切除后预后良好。 |
| 【关键词】神经节瘤 肿瘤 脊柱 外科手术 |
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| Clinical characteristics and surgical treatment of ganglioneuroma in spine |
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ABSTRACT
Objective:To summarize the clinical manifestation and diagnosis of ganglioneuroma in spine and investigate the clinical effect of surgical treatment.
Methods:The clinical data of 6 patients underwent a surgery for ganglioneuroma in spine from January 2008 to January 2015 were retrospectively analyzed. There were 4 males and 2 females,aged from 2 to 63 years old with an average of 34.6 years. The courses of disease were from 3 days to 17 years. Five patients complicated with superficial hypesthesia in correlative level of tumor,and the muscle strength under tumor plane had decreased at different levels,with the strength of gradeⅡ-Ⅳ。Two cases complicated with hypermyotonia and positive bilateral Hoffmann's and Babinski sign. Five cases were sporadic lesion in correlative spinal canal and one case complicated with the giant occupying lesion in thoracic cavity.
Results:Six operations had been performed including 5 en bloc and l subtotal resection. Postoperative pathological results showed tumor cells scattered or fasciculated inserted into Schwann cells in the stroma. In 2 patients complicated with radiculalgia before operation,1 case was relieved and 1 was invariant after operation. All 4 patients with preoperative dyscinesia in the limbs obtained improvement after operation. All the patients were followed up from 0.3 to 6.8 years with an average of 2.5 years. At the final follow-up,according to ASIA grade,5 cases were good and 1 case was invariant. During the follow-up,only 1 patient experienced chemoradiation because of merging ganglioneuroblastoma and receiving subtotal resection. No recurrence in other 5 cases.
Conclusion:Ganglioneuroma is a benign and rare tumors in spine. Clinically,radicular pain and sensory-motor disorders are the main manifestations. Its diagnosis depends on pathological examination. Prognosis of surgical treatment is good. |
| KEY WORDS Ganglioneuroma Neoplasms Spine Surgical procedures, operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄勇,吕振山,刘理迪,吴迪,李乔,张绍昆.脊柱节细胞神经瘤的临床特点与手术治疗[J].中国骨伤,2015,28(11):1013~1016 |
| 英文格式: | HUANG Yong,LYU Zhen-shan,LIU Li-di,WU Di,LI Qiao,ZHANG Shao-kun.Clinical characteristics and surgical treatment of ganglioneuroma in spine[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(11):1013~1016 |
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