CAJ | 학술논문

目的探讨枕骨大孔区神经鞘瘤的手术入路及切除技巧,以提高治疗效果.方法回顾性分析显微外科手术治疗的21例枕骨大孔区神经鞘瘤,根据肿瘤位置及生长方向将肿瘤分为2种类型:Ⅰ型(腹侧型)和Ⅱ型(背侧型);对于4例Ⅰ型患者选择远外侧入路,17例Ⅱ型患者选择枕下后正中入路.结果 21例患者肿瘤全切除18例(85.7％),次全切除3例.术后症状改善17例,病情稳定、无改善3例,病情恶化1例.10例患者术后出现并发症,术后随访3个月～2年,神经功能障碍均得到不同程度恢复.结论显微外科手术的技巧和手术入路的选择是提高枕大孔区神经鞘瘤治疗水平的关键.
목적 탐토침골대공구신경초류적수술입로급절제기교,이제고치료효과.방법 회고성분석현미외과수술치료적21례침골대공구신경초류,근거종류위치급생장방향장종류분위2충류형:Ⅰ형(복측형)화Ⅱ형(배측형);대우4례Ⅰ형환자선택원외측입로,17례Ⅱ형환자선택침하후정중입로.결과 21례환자종류전절제18례(85.7％),차전절제3례.술후증상개선17례,병정은정、무개선3례,병정악화1례.10례환자술후출현병발증,술후수방3개월～2년,신경공능장애균득도불동정도회복.결론 현미외과수술적기교화수술입로적선택시제고침대공구신경초류치료수평적관건.
Objective To explore the skills and surgical approaches of foramen magnum neurilemmoma.Methods A retrospective analysis was performed for 21 surgically treated patients with neurilemmoma involving the foramen magnum.According to the sites of the tumors,the classification was divided to type Ⅰ (located at ventral) and type Ⅱ (located at dorsal).The far-lateral approach was used in 4 cases of Type Ⅰ,while the midline approach for 17 cases of Type Ⅱ.Results Total resection was achieved in 18 cases (85.7％) and subtotal in 3 cases.17 patients had improvement in their neurological status,3 unchanged,and 1 aggravation.10 patients developed new postoperative neurological deficits and other complications.The patients were followed-up from 3 months to 2 years,and the neurological functions were found to recover in varying degrees.Conclusions The surgical approaches and microsurgery skills were the keys to improve the efficacy of the treatment of foramen magnum neurilemmoma.