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目的探讨颈椎后路肿瘤切除植骨融合内固定治疗颈椎管内肿瘤的疗效。方法手术治疗颈椎管内肿瘤16例(神经鞘瘤9例,脊膜瘤4例,神经纤维瘤3例),16例在切除肿瘤后均行颈椎后路椎弓根螺钉内固定及植骨融合术,术中行脊髓神经电生理监测对脊髓功能进行判断,术前术后行JOA评分。结果本组16例均后路一次手术完全切除肿瘤,术中脊髓监测均无脊髓损伤发生,平均随访12个月(3~29个月),JOA评分有明显改善,肿瘤无复发,术后无脊髓损伤或症状加重,无血管、神经损伤等并发症发生,术后无内固定松动或断裂发生,固定效果满意,术后复查x线及CT提示相应植骨部位均形成骨性融合。结论颈椎管内肿瘤行后路肿瘤切除及椎弓根螺钉内固定可取得良好的临床疗效。
Objective To investigate the curative effect of posterior cervical tumor resection and bone grafting and internal fixation for the treatment of cervical spinal tumors. Methods Sixteen patients (9 schwannoma, 4 meningioma, 3 neurofibroma) underwent surgical treatment of cervical canal tumor. 16 patients underwent posterior cervical pedicle screw fixation and bone graft fusion after resection of the tumor The intraoperative spinal cord electrophysiological monitoring of spinal cord function to determine the preoperative and postoperative JOA score. Results All the 16 cases underwent posterior resection of the tumor in one operation. There was no spinal cord injury in the spinal cord during the follow-up. The average follow-up was 12 months (range 3 to 29 months), JOA score was significantly improved, Spinal cord injury or worsening of symptoms, no vascular, nerve injury and other complications occurred, no internal fixation loosening or rupture, the fixation effect is satisfactory, postoperative review of x-ray and CT bone formation corresponding site of bone fusion. Conclusion Cervical spinal canal tumor line posterior resection and pedicle screw fixation can achieve good clinical efficacy.