Leptomeningeal metastasis (LM) is caused by the spread of malignant tumor cells into the subarachnoid space.However,classification and staging of LM in the spinal canal is rare in the literature.The authors reviewed t...Leptomeningeal metastasis (LM) is caused by the spread of malignant tumor cells into the subarachnoid space.However,classification and staging of LM in the spinal canal is rare in the literature.The authors reviewed the records of 58 Chinese patients with LM for clinical features,neuroimaging,and treatments.Gadolinium-enhanced magnetic resonance imaging (MRI) of brain and spinal cord were performed in all patients.Removal of intracranial tumors was performed in all patients and diagnoses were confirmed by histology.The study group consisted of 58 patients,with 29 cases presenting with intraspinal symptoms.Of the 58,8 patients underwent intraspinal tumor removal,8 received radiotherapy alone,9 received chemotherapy alone,and 34 patients received combined radiochemotherapy.We classified LM into 3 types:type L or leptomeninges LM,is subdivided into 2 subtypes (subtype LI and LII (a,b)),type N or nerve root LM is subdivided into 2 subtypes (subtype NI and NII (a,b)),and type M or mixed-type LM.We also divided LM into stages of I-IV according to the symptoms and the volume of the tumor based on spinal axial MRI.Type LI LM often occurs in patients with intracranial and intraspinal tumors found simultaneously.Patients who receive surgery for intracranial tumors may present with type N LM.Surgery is suitable for patients with NI LM and LIIb LM in stages III-IV,presenting with severe spinal symptoms.The prognosis is better for type N LM than type L LM.展开更多
目的观察后方韧带复合体回植重建椎管内肿瘤切除术后的脊柱稳定性。方法回顾性分析总结我科2008年7月至2013年7月43例确诊为椎管内肿瘤患者的临床资料,43例患者均采用微型钛板对游离的椎板进行固定。观察患者术后有无并发症,术后6个月X...目的观察后方韧带复合体回植重建椎管内肿瘤切除术后的脊柱稳定性。方法回顾性分析总结我科2008年7月至2013年7月43例确诊为椎管内肿瘤患者的临床资料,43例患者均采用微型钛板对游离的椎板进行固定。观察患者术后有无并发症,术后6个月X线、CT影像学复查截骨断面是否愈合、椎管宽度是否良好。结果手术时间130~220 min,平均150 min。失血量200~750 m L,平均340 m L。术后随访6~42个月,所有病例术后未出现医源性脊髓损伤,未出现动脉损伤、脊髓损伤、脊神经根局部异常积液等并发症,术后动力位片显示棘突椎板回植术后脊柱活动度基本得以保留。结论微型钛板固定通过回植后方韧带复合体可恢复脊柱的稳定性,在治疗椎管内肿瘤方面具有良好的优越性和临床可行性。展开更多
文摘Leptomeningeal metastasis (LM) is caused by the spread of malignant tumor cells into the subarachnoid space.However,classification and staging of LM in the spinal canal is rare in the literature.The authors reviewed the records of 58 Chinese patients with LM for clinical features,neuroimaging,and treatments.Gadolinium-enhanced magnetic resonance imaging (MRI) of brain and spinal cord were performed in all patients.Removal of intracranial tumors was performed in all patients and diagnoses were confirmed by histology.The study group consisted of 58 patients,with 29 cases presenting with intraspinal symptoms.Of the 58,8 patients underwent intraspinal tumor removal,8 received radiotherapy alone,9 received chemotherapy alone,and 34 patients received combined radiochemotherapy.We classified LM into 3 types:type L or leptomeninges LM,is subdivided into 2 subtypes (subtype LI and LII (a,b)),type N or nerve root LM is subdivided into 2 subtypes (subtype NI and NII (a,b)),and type M or mixed-type LM.We also divided LM into stages of I-IV according to the symptoms and the volume of the tumor based on spinal axial MRI.Type LI LM often occurs in patients with intracranial and intraspinal tumors found simultaneously.Patients who receive surgery for intracranial tumors may present with type N LM.Surgery is suitable for patients with NI LM and LIIb LM in stages III-IV,presenting with severe spinal symptoms.The prognosis is better for type N LM than type L LM.
文摘目的观察后方韧带复合体回植重建椎管内肿瘤切除术后的脊柱稳定性。方法回顾性分析总结我科2008年7月至2013年7月43例确诊为椎管内肿瘤患者的临床资料,43例患者均采用微型钛板对游离的椎板进行固定。观察患者术后有无并发症,术后6个月X线、CT影像学复查截骨断面是否愈合、椎管宽度是否良好。结果手术时间130~220 min,平均150 min。失血量200~750 m L,平均340 m L。术后随访6~42个月,所有病例术后未出现医源性脊髓损伤,未出现动脉损伤、脊髓损伤、脊神经根局部异常积液等并发症,术后动力位片显示棘突椎板回植术后脊柱活动度基本得以保留。结论微型钛板固定通过回植后方韧带复合体可恢复脊柱的稳定性,在治疗椎管内肿瘤方面具有良好的优越性和临床可行性。
