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依阳凭
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1 Chin J Min Inv Surg November 2014 Vol. 14. No * 刘彬王振宇谢京诚马长城陈晓东李振东赵薇 ~ ~ ± % % % McCormick Ⅰ 10 Ⅱ 17 Ⅲ 10 Ⅳ McCormick Simpson Ⅰ % Ⅱ % 1 2 Ⅰ 15 Ⅱ 15 Ⅲ 7 Ⅳ 4 Z = P = ~ ± Ⅰ 30 Ⅱ 8 Ⅲ 3 Z = P = > 36 Ⅰ 8 Ⅱ 2 Ⅲ 2 R A doi /j. issn Posterior Midline Approach Treatment for Meningioma in Thoracic Spinal Canal a Report of 41 Cases Liu Bin Wang Zhenyu Xie Jingcheng et al. Department of Neurosurgery Peking University Third Hospital Beijing China Corresponding author Wang Zhenyu wzy502@ hotmail. com Abstract Objective To investigate the follow-up outcomes of posterior midline approach treatment for patients with meningioma in thoracic spinal canal. Methods A total of 41 cases with meningioma in thoracic spinal canal from January 2004 to December 2013 in our hospital were studied included 35 females and 6 males aged from 24 to 84 years old mean ± years old. MRI showed tumors located in the dorsal side of spinal cord in 16 cases 39. 0% in ventral and lateral-ventral side in 13 cases 31. 7% and in lateral side in 12 cases 29. 3%. According to the McCormick scores there were 10 cases of grade Ⅰ 17 cases of grade Ⅱ 10 cases of grade Ⅲ and 4 cases of grade Ⅳ preoperatively. The operation was performed through posterior median line incision to cut off the intraspinal tumor under microscope with laminectomy 34 cases or lamiplasty 7 cases. A total of 22 cases of operation was under electrophysiologic monitoring. Postoperative follow-up of spinal cord functions was evaluated by McCormick scores. Results There were no operative deaths. According to the Simpson classification there were 13 cases 31. 7% of class Ⅰ resection and 28 cases 68. 3% of class Ⅱ resection. Postoperative incisional infection occurred in 1 case which was cured by debridement. At the second week after operation there were 15 cases of grade Ⅰ 15 cases of grade Ⅱ 7 cases of grade Ⅲ and 4 cases of grade Ⅳ as the McCormick scores without significant differences as compared with preoperation Z = P = A total of 41 patients were followed up for 4-73 months mean ± months. Local recurrence was found in 1 case. At the last follow-up evaluation there were 30 cases of grade Ⅰ 8 cases of grade Ⅱ and 3 cases of grade Ⅲ with spinal cord functions significantly improved Z = P = Among 12 cases followed up for more than 36 months there were 8 cases of grade Ⅰ 2 cases of grade Ⅱ and 2 cases of grade Ⅲ. Conclusions The posterior thoracic midline approach treatment for meningioma is effective. Intraoperative elaborative microscopic performance and application of electrophysiologic monitoring can be helpful to get a better prognosis. Key Words Meningioma Thoracic spinal canal Surgery Therapeutic effect * wzy502@ hotmail. com

2 ~ ~ % % 24 ~ ± ~ ± % % % Ⅲ ~ Ⅳ McCormick 3 Ⅰ 10 Ⅱ 17 Ⅲ 10 Ⅳ 4 Ⅳ T 1 ~ T 4 17 T 5 ~ T 8 10 T 9 ~ T < 1 cm ~ 2 cm 20 2 ~ 3 cm 12 3 ~ 4 cm % % % C X Chin J Min Inv Surg November 2014 Vol. 14. No Cadwell Cascade Elite32 SEP motor evoked potential MEP electromyography EMG 5 MEP 6 SEP 70% MEP McCormick 3 Ⅰ Ⅱ Ⅲ SPSS18. 0 Wilcoxon P < ~ 300 min ± min Simpson 1 Ⅰ % Ⅱ % % % somatosensory evoked potential SEP % % % % 2 McCormick Ⅰ Simpson Ⅰ 15 Ⅱ 15 Ⅲ 7 Ⅳ % % % ~ ± % % 2

3 Chin J Min Inv Surg November 2014 Vol. 14. No McCormick 4. 9% 1 4 McCormick Ⅰ Ⅱ Ⅲ Ⅳ Ⅰ 30 Ⅱ 8 Ⅲ Z 1-2 P Z 1-3 P > 36 Ⅰ 8 Ⅱ 2 Ⅲ cm ~ 3 2 Ⅳ Ⅳ 13 Ⅱ ~ Ⅲ Ⅲ 6 Ⅰ ~ Ⅱ Ⅳ 63 Ⅲ ~ 5 3 Ⅱ Ⅳ 17 Ⅲ ~ Ⅱ Ⅲ 21 Ⅱ % Ⅱ Ⅲ Ⅳ

4 1014 MR 31. 7% Uchida Kim % 23 1 ~ Ⅱ 10 Ⅰ 95. 1% 39 / MEP CT 12 > Lyons 19 Ⅰ 8 Ⅱ 2 Ⅲ Yamamuro 20 Simpson Ⅱ 25 Simpson Ⅰ Ⅰ Ⅱ Ⅲ 60% Ⅱ Chin J Min Inv Surg November 2014 Vol. 14. No /5 T 4 ~ T > 2 cm Zhu Q Qian M Xiao J et al. Myelopathy due to calcified meningiomas of the thoracic spine minimum 3-year follow-up after surgical treatment. J Neurosurg Spine McCormick PC Torres R Post KD et al. Intramedullary ependymoma of the spinal cord. J Neurosurg Voulgaris S Alexiou GA Mihos E et al. Posterior approach to ventrally located spinal meningiomas. Eur Spine J

5 Chin J Min Inv Surg November 2014 Vol. 14. No PTRA Cooper CJ Murphy TP Cutlip DE et al. Stenting and medical therapy for atherosclerotic renal-artery stenosis. N Engl J Med Bruno RM Daghini E Versari D et al. Predictive role of renal resistive index for clinical outcome after revascularization in hypertensive patients with atherosclerotic renal artery stenosis a monocentric observational study. Cardiovasc Ultrasound Webb TN Ramratnam M Evans RW et al. Atherosclerotic renal artery stenosis as a cause for hypertension in an adolescent patient. Pediatr Nephrol Textor SC Lerman LO. Reality and renovascular disease when does renal artery stenosis warrant revascularization Am J Kidney Dis G Habibian MR Delbeke D Martin WH et al. Nuclear Medicine Imaging-A Teaching File. Philadelphia Lippincott Williams & Wilkins Grisk O Rettig R. Interactions between the sympathetic nervous system and the kidneys in arterial hypertension. Cardiovasc Res Burke SL Evans RG Head GA. Effects of chronic sympathoinhibition on renal excretory function in renovascular hypertension. J Hypertens ( 责任编辑 : 王惠群 ) 檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷檷 Uchida K Nakajima H Yayama T et al. Immunohistochemical Chiari. findings of multiple ossified en plaque meningiomas in the thoracic Tuli J Drzymalski DM Lidov H et al. Extradural en-plaque spinal meningioma with intraneural invasion. World Neurosurg e5 - e13. 9 Tsai CY Tsai TH Lin CH et al. Unusual exophytic neurocytoma of thoracic spine mimicking meningioma a case report and review of the literature. Eur Spine J Suppl 2 S239 - S Sahni D Harrop JS Kalfas IH et al. Exophytic intramedullary meningioma of the cervical spinal cord. J Clin Neurosci Maiuri F De Caro ML de Divitiis O et al. Spinal meningiomas agerelated features. Clin Neurol Neurosurg Mekitarian FE Horigoshi NK Carvalho WB et al. Primary spinal meningioma in a 10-year-old boy. Arquivos de Neuro-psiquiatria Knafo S Lonjon G Vassal M et al. Spinal cord compression due to undiagnosed thoracic meningioma following lumbar surgery in an elderly patient a case report. Orthop Traumatol Surg Res spine. J Clin Neurosci Kim CH Chung CK. Surgical outcome of a posterior approach for large ventral intradural extramedullary spinal cord tumors. Spine Phila Pa E531 - E ZACKS A. Atlanto-occipital fusion basilar impression and block vertebrae associated with intraspinal neurofibroma meningocele and von Recklinghausen s disease. Radiology Lyons M Windgassen E Kinney C et al. Thoracic meningioma masquerading as chronic abdominal pain. Turk Neurosurg Yamamuro K Seichi A Kimura A et al. Histological investigation of resected dura mater attached to spinal meningioma. Spine Phila Pa E E Menku A Koc RK Oktem IS et al. Laminoplasty with miniplates for posterior approach in thoracic and lumbar intraspinal surgery. Turk Neurosurg ( 责任编辑 : 王惠群 )

. 500. 中国骨与关节杂志 2015 年 6 月第 4 卷第 6 期 Chinese Journal of Bone and Joint, June 2015, Vol 4, No.6 and difficulties of the surgery and raise the

. 500. 中国骨与关节杂志 2015 年 6 月第 4 卷第 6 期 Chinese Journal of Bone and Joint, June 2015, Vol 4, No.6 and difficulties of the surgery and raise the 中国骨与关节杂志 2015 年 6 月第 4 卷第 6 期 Chinese Journal of Bone and Joint, June 2015, Vol 4, No.6. 499.. 论著 Original article. 极重度脊柱侧后凸患者的后路一期小切口撑开联合二期全脊柱截骨术治疗谭荣马华松吴