Clinical Analysis Of Surgical Treatment Of 37 Patients With Extramedullary Tumor

Baekground and objective:Intraspinal tumors are spinal surgery and neurosurgery, one of commondiseases and frequently-occurring disease, nervous system tumors account for10% to 15%, of which intradural extramedullary tumors account for 60 ~ 70%, toneurogenic tumors and meningioma main. Although in recent years, research andunderstanding of the disease has increased over the previous, but the incidence ofthe disease characteristics, diagnosis and treatment, prognosis, such as acomprehensive analysis was relatively small. This research work is to explore theSino-Japanese Friendship Hospital, 37 cases of intradural extramedullary tumorsof the study the incidence of this disease characteristics, surgical treatment andprognosis.Methods:Sino-Japanese Friendship Hospital, 2008 ~ 2010 with complete data in 37cases of intradural extramedullary tumor patients in this study. Including 15males and 22 females: age 15 ~ 64 (48.12±8.14) years of age; 12 cases of lumbar, thoracic 15 cases, 10 cases of cervical spine. design "cases of intraspinaltumors Tables" to collect clinical data of each patient, including name, sex, age,symptoms, past history, signs, radiographic manifestations, diagnosis, surgicaltreatment, carried out retrospective study and analysis, and statistical data inputstatistical software SPSSIO.0, were statistically analyzed.SurgicaSurgical method:Pre-operative lesions were performed under X-corresponding segment of thelamina orientation. The majority of patients after general anesthesia to take proneposition, the small number of patients taking lateral position, lesion side up. Tolocate marked as the center, according to the size of the tumor to take differentlengths of the median longitudinal incision, dissected to the spine ligament afterthe lesion side subperiosteal separation of paraspinal muscle, exposed lamina,generally outside the lateral margin of no more than articular process . Reveallesions of the lamina segments, retention as well as the interspinous ligament onthe spine. Choose to use according to the tumor the size of the lamina bone bitingforceps or some other burr to remove the corresponding lamina, lateral to hold asmall facet, medial to the base of spinous process. In addition to yellow ligamentbite exposed epidural. Cut as close as possible the surface of tumor epidural, firstcut the tumor capsule line of partial tumor capsule, and then a pole separation ofthe tumor, the tumor capsule institute, carefully isolated tumor capsule and spinalcord or nerve root adhesion, electrocoagulation tumor feeding arteries, resectionof tumor, and complete hemostasis, suture epidural paraspinal muscles in the interspinous ligament suture, the suture tight fascia.ResultsResults: INone of this group of patients after the emergence of new symptoms ofneurological damage. Patients were followed up 6 months-2 years, 18 cases ofpatients with neuropathic pain disappeared completely in 14 cases, 4 casessignificantly reduced; 14 cases of patients with eight cases of sensory disturbancegradually returning to normal, 6 patients with different degrees of improvement;11 cases of movement disorder patients, 7 cases of preoperative muscle strength 4,walking with crutches or arm under the patient, after 3 to 4 months, musclestrength returned to 5, can independently walk and resume a normal life andability to work; two cases of preoperative strength 3, after 8 months pairs oflower limb muscle strength returned to 5; 6 cases of preoperative sphincterdysfunction 10 weeks after surgery, 4 a complete return to normal. Was no tumorrecurrence during follow-up, no one cases of spinal instability occurs.Conclusion:Intradural extramedullary tumors account for intraspinal tumors in 60 to70% in order to meningeoma neurogenic tumors and dominated. Can be seen inany segment of the spinal cord and cauda equina to thoracic most. Meningiomawomen than men, young men Zeyi neurogenic tumors more common. The peakincidence of 45 to 60 years old, accounting for 67.32% total number of cases.Intraspinal tumor incidence has the following characteristics:①an earlymanifestation of occult, post, there may be an intolerable pain, showing progressive increase at night obviously.②pain at the same time or shortlyappears diminished muscle strength, sensory disturbances, sphincter dysfunction,and so on, and progress rapidly, simultaneous pathological sign.③easily misseddiagnosis and misdiagnosis, MR I is the preferred best method.④conservativetreatment is invalid. Surgery is the treatment of intradural extramedullary tumorsfundamental way of protecting as much as possible not to aggravate the injury inthe spinal cord under the premise, and strive to achieve complete resection oftumor, and the restoration of the stability of the posterior column of the spine.Tight seals or repair dura mater to prevent cerebrospinal fluid leakage [1]. surgeryefficacy and nervous tissue compression of time, scope, degree of tumor nature,location and degree of removal. Tumor site, tumor nature, early diagnosis, earlysurgery, the appropriate body posture and approach, a skilled surgical techniques,affect the efficacy of intraspinal tumors key factor.