【摘要】 目的 探讨如何早期诊断椎管内肿瘤与早期治疗，避免误诊、漏诊、误治。方法 回顾分析37例椎管内肿瘤早期诊断与治疗经验和引起误诊、漏诊的原因及手术操作原则。结果 首诊确诊率27%，而首诊误诊率达59%，1例为多发神经纤维瘤，第一次手术漏诊术后3年其他部位再发，良性肿瘤30例瘤体完整摘除，1例行包膜内切除；1例行后路脊髓中央管切开2.5cm；2例切除一侧关节突关节。结论 详细的询问病史，严格规范的体格检查对早期诊断椎管内肿瘤、避免误诊、漏诊至关重要，椎管内神经纤维瘤有多发倾向，而熟练的脊柱外科和显微神经外科的手术技巧是保证良性髓外占位病变手术效果及防止脊柱脊髓手术副损伤的前提条件。

    【关键词】 肿瘤；椎管内；早期诊断；早期治疗

    Early diagnosis and treatment of the intraspinal tumor

    XU Shui-yang,LUO Jian-jun,Liu jian,et al.

    Department of Orthopedic,No.160 Hospital of the PLA,Jiaozuo 454003,China

    【Abstract】 Objective To research how to achieve diagnosis and treatment early in the patients with intraspinal tumors, and avoid to misdiagnosis and mistreatment.Methods Retrospective analysis of the clinical experience in early diagnosis and treatment,the cause of misdiagnosis,and the principle in surgery in 37 cases with intraspinal tumors.Results The accurate diagnosis rate was only 27% at initial period, as well as the misdagnosis rate was high to 59%. 1 case with multiple neurofibroma was ocurred again in another place after 3 years in first operation. The benign turmors in 30 patients were completetly resected,1 case was did intracapsular turmor；The central tube of spinal cord was opened up for 2.5cm long by posterior approache in 1 case;One side of facet joint was resceted in 2 csae.Conclusion It was the key in especial to collecting patient’s complaints, history and clinical smptoms and signs in detail, and doing physical examination in standard and speciality related with early diagnosis, avoid to misdiagnosis.A neurilemoma could be take place at multiple in spinal canal. As well as it was an important role to hand good operating technic in spinal and microneurosurgery for obtaining a result of less trauma, less complication and better effect in the patients with benign turmors outside spinal corde. ......