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目的分析腰椎管神经鞘瘤的临床特点。方法24例腰椎管神经鞘瘤患者结合临床表现和MRI明确诊断,行全椎板切开+肿瘤切除术,术中注意细密关闭硬膜,术后静脉应用甲强龙。结果15例患者肿瘤切除同时行椎弓根螺钉内固定,18例患者肿瘤完整剥离切除,6例与马尾神经分离困难,行单根神经切断。后2例出现脑脊液漏,对症处理后治愈。术后次日所有患者臀部疼痛症状消失,5例患者出现一侧足背麻木,经对症处理后术后一月缓解。结论MRI是诊断腰椎管神经鞘瘤的有效辅助手段,其手术预后较好。
Objective To analyze the clinical features of schwannoma of the lumbar canal. Methods Twenty - four patients with schwannoma of the lumbar canal were diagnosed in combination with clinical manifestations and MRI. All patients underwent complete laminectomy plus tumor resection. Meticulous attention was paid to close the dura mater carefully. Postoperative intravenous administration of methylprednisolone was performed. Results Fifteen patients underwent resection of the tumor with pedicle screw fixation. Eighteen patients underwent complete tumor resection and excision. Six of them had difficulty in separating from the cauda equina nerve and had a single nerve transection. After 2 cases of cerebrospinal fluid leakage, symptomatic treatment cured. The pain in the buttocks of all the patients disappeared on the next day after surgery. Five patients showed numbness on one side of the dorsum of the feet and were relieved after one month after symptomatic treatment. Conclusion MRI is an effective method to diagnose schwannoma of the lumbar spinal canal, and its prognosis is good.