Retrospective Analysis Of The Diagnosis And Treatment In Cervical Intraspinal Tumors

Objective: To summarize and analysis the diagnosis and surgical treatment of cervical intraspinal tumors,and to investigate the imaging features of cervical intraspinal tumors,the methods to improve the diagnostic accuracy,and the precise surgery.Methods: Twenty patients who underwent operations for tumor in cervical spinal canal in our hospital from January 2013 to June 2017 were reviewed retrospectively.There were 8 males and 12 females,and the ratio of male and female is 2:3.The mean age of the patients was 48.6 years old(range 27 to 65).The mean course of cervical intraspinal tumors was 26.2 years.Imaging examination which were included cervical X-ray of positive position and lateral position and dynamic position,and cervical CT scan or CT three-dimensional reconstruction,and cervical MRI or enhanced magnetic resonance imaging.Contrast with postoperative pathological results,we analysis the accuracy of imaging diagnosis and localization.The operation method was total laminectomy approach with nail-rod system fixation.We recorded JOA score and ASIA grade of patients at admission and last follow-up,through JOA and ASIA grade we analysis clinical of efficacy surgical treatment.Results: Responsible segments: C1-2 2patients,C2 2 patients,C2-3 2 patients,C4-5 2 patients,C4-6 2 patients,C4-7 2 patients,C7 6 patients,C7-T1 2 patients.Lesions of responsible segments: 1 segment 8 patients,2 segments 8 patients,3 segments 2 patients,4 segments 2patients.Patients of upper cervical intraspinal tumors were 6 and patients of lower cervical intraspinal tumors were 18.In this study,we investigated the location of the tumor,there were 4 intramedullary tumors,14 cases of subdural-extramedullary tumors and 2 epidural tumors.The accuracy of imaging localization was 95.0%.The pathologic diagnosis was 8 cases of meningioma,6 cases of neurinoma,2 cases of ependymoma,2 cases of astrocytoma,2 cases of capillary hemangioma,and the accuracy of imaging diagnose is 85.0%.JOA score rise by an average of 10.34±0.34 at admission to 14.80±0.39 follow-up(P<0.05),recovery rate is 68.27±4.26%.Compared to admission,14 cases had improved of 1 or 2 grades in ASIA grade.During the follow-up,the cervical vertebral stability was good,and there were no tumor recurrence.Conclusion:Through X-ray,CT and MRI,we can make the diagnosis and get the localization accurately.Surgery is the most effective way to treat the cervical intraspinal tumors.Total laminectomy approach with nail-rod system fixation can improve the clinical symptoms of the patients better,and has a good effect on the recovery of nerve function,and reconstruct cervical stability.