关键词:  , 颈胸交界, 　神经鞘膜瘤, 　手术指征, 　后入路

Abstract:

Objective　To identify the surgical indication of one stage posterior approach for resection of cervicothoracic junction schwannoma.　Methods　From Jan 2005 to Jan 2016, cervicothoracic junction schwannoma cases admitted in our department were selected according to following indication: ①epidural tumor; ②lateral growth pattern which went through C6/7, C7/T1, T1/2 foramen; ③the diagnosis of schwannoma was suggested by MRI. ASIA motor score, radiological images features, operative time, bleeding amount, complications were recorded and analyzed after follow-up. 　Results　14 cases were collected, including 8 male and 6 female, with an average age of 51.1y (28~74 y). 10 case were successfully managed by one stage posterior approach for resection of cervicothoracic junction schwannoma; however, 4 cases were sent to head and neck surgery department for second stage anterior approach tumor resection. The largest tumor size within the vertical line of the tip of transverse process was the indication of one stage posterior operation. All cases were successfully followed up for 10 to 48 month, averaging 23.9 month. There was no recurrence, and operative segments were solid fused. Preoperative ASIA motor score was improved from 81.71±6.63 to 97.14±1.29 at final follow-up, and the difference was significant（P<0.05）.　Conclusion　MRI should be used to diagnose the tumor preoperatively. After careful patient selection, one stage posterior approach for resection of cervicothoracic junction schwannoma could be carried out with a satisfied clinical outcome, few complication and good prognosis.

Key words:  , Cervicothoracic junction, 　Schwannoma, 　Surgical indication, 　Posterior approach