Diagnosis and Surgical Treatment of Multiple Intradural Extramedullary Tumors / 中国微创外科杂志

ABSTRACT

Objective To investigate the diagnosis and treatment of multiple spinal intradural extramedullary tumors.Methods Totally 15 patients(11 men and 4 women) with multiple spinal intradural extramedullary tumors were enrolled in this study.The patients aged from 16 to 81 years with a mean of(51.0?21.2) years.The mean course of the disease was(11.0?7.6) months(range2-27 months).In the patients,no skin neurofibroma or coffee spots were detected;brain MR showed no abnormalities.Enhanced MR revealed totally 46 spinal intradural extramedullary tumors,35 of which ≥0.5 cm in diameter,involving the cervical segment in 1 case,the thoracic segment in 5,and lumbar and sacrum segments in 12.All the patients received tumorectomy via the posterior midline approach.If the tumor was less than 1 cm,hemilaminectomy was performed under a microscope;the tumor was removed completely,while crucial nerves supplying the tumor were conserved as much as possible.When it is difficult to separate the nerves,we freed the roots of the nerves at our best ability,so that to carry out anastomosis of the roots after removing the tumor.Antibiotics and hormone therapy were administered after the operation,and the patients were required to wear neck/waist support brace for 2 months,and practice the back and waist muscles at the meantime.Results Among the 15 cases,total resection of the spinal tumors was performed on 12 patients(33 tumors were removed),of which one patient received anastomosis of the nerve roots.In the other three patients,two were diagnosed as having scattered multiple small neurofibroma or Schwannoma(