CAJ | 학술논문

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。
목적：탐토경추후로종류절제식골융합내고정치료경추관내종류적료효。방법수술치료경추관내종류16례（신경초류9례，척막류4례，신경섬유류3례），16례재절제종류후균행경추후로추궁근라정내고정급식골융합술，술중행척수신경전생리감측대척수공능진행판단，술전술후행 JOA 평분。결과본조16례균후로일차수술완전절제종류，술중척수감측균무척수손상발생，평균수방12개월（3~29개월），JOA 평분유명현개선，종류무복발，술후무척수손상혹증상가중，무혈관、신경손상등병발증발생，술후무내고정송동혹단렬발생，고정효과만의，술후복사 X 선급 CT 제시상응식골부위균형성골성융합。결론경추관내종류행후로종류절제급추궁근라정내고정가취득량호적림상료효。
Objective To investigate the efficacy of posterior tumorectomy,bone graft fusion and internal fixation for cervical intraspinal tumor. Methods A total of 16 cases of cervical intraspinal tumor were enrolled and received surgical treatment,including 9 cases of schwannoma,4 cases of meningioma and 3 cases of neurofibroma. All patients accepted posterior cervical pedicle screw fixation and bone graft fusion after tumorectomy. Electrophysiological activity of the spinal nerves was monitored during the operation and JOA score was analyzed before and after operation. Results All tumors in the 16 patients were primarily removed. Intraoperative electrophysiological monitoring revealed no spinal cord injuries. The follow-up time ranged from 3 to 29 months,with an average of 12 months. Patients' JOA scores were obviously improved. There were no recurrence,spinal cord injuries and deterioration,vascular and nerve injuries and loose or broken fixation. Postoperative X-ray and CT scan indicated posterolateral bone graft fusion. Conclusion Posterior tumorectomy and cervical pedicle screw fixation can achieve good clinical efficacy in the treat-ment of cervical intraspinal tumor .