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目的探讨环枕区及颈段椎管哑铃形肿瘤的手术方法。方法对经改良枕下远外侧入路和颈后中线入路手术治疗的26例环枕区及颈段椎管哑铃形肿瘤病人的临床资料进行回顾性分析。结果肿瘤一期全切除23例,次全切除3例,无手术死亡。随访1~9年,所有患者均恢复良好,1例脊索瘤次全切除术后2年复发。结论经改良枕下远外侧入路和颈后中线入路手术是治疗环枕区及颈段椎管哑铃形肿瘤的一种较理想方法,具有术野开阔、肿瘤显露充分、全切率高等优点。
Objective To investigate the surgical method of spinal dumbbell tumor in the occipital region and cervical region. Methods The clinical data of 26 patients with ring dumbbell and cervical canal dumbbell tumor treated with modified suboccipital distal approach and posterior median neck approach were analyzed retrospectively. Results Totally 23 cases underwent primary total resection and 3 cases underwent subtotal resection without any operative death. All the patients recovered well from 1 to 9 years of follow-up. One case had recurrence 2 years after subtotal resection of chordoma. Conclusions The modified suboccipital distal approach and posterior midline approach is an ideal method for the treatment of dumbbell tumors in the annular zone and cervical segment. It has the advantages of open field, full tumor presentation and high total cut rate .