目的:探讨单纯椎管内海绵状血管瘤(cavernous hemangioma,CH)的诊断与外科治疗效果。方法:回顾性分析2002年1月~2010年11月18例行手术治疗并经病理检查证实的单纯椎管内CH患者的临床资料,并依据Aminoff-Logue评分标准对手术前后患者脊髓功能进行评价。结果:18例患者术前均有相应神经系统损害表现。术前均行脊柱MRI检查,其中6例术前MRI检查有典型的CH表现,其MRI诊断与术后病理检查结果相符,17例为单发,1例L2~L3和S1节段各1个肿瘤,10例肿瘤累及2~3个节段。手术均经后正中入路,3例急性发病患者在出血急性期急诊行手术治疗,其余患者均在发现肿瘤早期(1周内)行肿瘤切除术,17例单发病例均行肿瘤全切除,另1例患者仅切除引起症状的L2~L3节段肿瘤,无症状的较小的S1节段肿瘤未行手术切除;手术时间170±20min,术中出血量280±40ml,术中均未出现相关并发症。术后均经病理检查证实为CH。术前Aminoff-Logue评分3~11分,平均6.0±2.8分;术后0~11分,平均4.2±3.8分,术后评分与术前比较有显著性差异(P<0.05)。术后脊髓功能Aminoff-Logue分级12例较术前改善,4例无明显变化,2例恶化,无死亡病例。随访2个月~5年,平均30个月,8例门诊随访患者影像学检查均未见肿瘤复发;其余患者电话随访,症状较术前改善7例,无明显变化3例。结论:MRI检查有典型的CH表现时对椎管内CH有诊断价值;对于有相应神经系统症状的椎管内CH患者,应积极、早期行肿瘤切除术,可获得良好效果。 Objective: To investigate the diagnosis and surgical treatment of simple intramedullary cavernous hemangioma (CH). Methods: A retrospective analysis of clinical data of 18 patients with CH who underwent surgical treatment and confirmed by pathology from January 2002 to November 2010 was retrospectively analyzed. The spinal cord function was evaluated according to Aminoff-Logue score before and after operation . Results: All the 18 patients had corresponding neurological damage before operation. Spinal MRI was performed preoperatively, including 6 cases of preoperative MRI with typical CH manifestations. The MRI diagnosis was consistent with the postoperative pathological findings, 17 cases were solitary and 1 case had L2 ~ L3 and S1 Tumors, 10 cases of tumors involving 2 to 3 segments. Surgical operation was followed by the median approach. Three patients with acute disease underwent emergency surgery in the acute stage of bleeding. The remaining patients underwent tumor resection in the early stage of the tumor (within 1 week). Total tumor removal was performed in 17 cases of single disease, The other 1 patient had only resection of the L2 ~ L3 segmental tumor, and the asymptomatic S1 tumor was not surgically resected. The operation time was 170 ± 20min and the intraoperative blood loss was 280 ± 40ml Related complications. Postoperative pathological examination confirmed CH. Preoperative Aminoff-Logue score 3 to 11 points, an average of 6.0 ± 2.8 points; 0 to 11 points after surgery, an average of 4.2 ± 3.8 points, postoperative score compared with preoperative significant difference (P <0.05). Postoperative spinal function Aminoff-Logue grade 12 cases improved compared with preoperative, 4 cases no significant change, 2 cases of deterioration, no deaths. The follow-up ranged from 2 months to 5 years, with an average of 30 months. No tumor recurrence was found in imaging examination of 8 outpatient follow-up patients. The remaining patients were followed up by phone. The symptoms were improved in 7 cases compared with those before operation. There were no obvious changes in 3 cases. CONCLUSION: The typical CH findings in MRI are valuable for the diagnosis of CH in the spinal canal. For patients with CH with corresponding neurological symptoms, active resection of the CH should be performed in the early stage. Good results can be achieved.