上颈椎细胞神经鞘瘤:1例报告与文献综述

Upper cervical cellular schwannoma: a case report and literature review

摘要:

上颈椎细胞性神经鞘瘤好发于好发 40~50 岁患者，但发病率极低。其临床症状不典型，早期多无明显的脊髓压迫症状，常为根性刺激症状，且缺少明显的影像学特征，与颈椎病、恶性外周神经鞘瘤等难以区分，易误诊误治。该病一经发现应积极手术治疗，也是目前唯一且最有效的治疗方法。手术方法有半椎板切除术、整块全脊椎切除手术、囊内切除术、显微外科手术技术等术式。手术效果好，整体临床效果满意。脊柱外科医师应根据不同影像表现、肿瘤侵占情况、功能需要、颈椎术后稳定性等因素，选择合理手术方案。

Abstract:

Upper cervical cellular schwannoma is more likely to occur in the patients aged 40 to 50 years, but its incidence is extreme- ly low. The clinical symptoms are atypical with no obvious symptoms of spinal cord compression in the early stage, whereas often radicular irritation, and lack of obvious imaging features. This tumor is difficult to be distinguished from cervical spondylosis and malignant peripher- al nerve sheath tumors, prone to be misdiagnosed and mistreated. Once discovered, the disease should be surgically treated actively, which is the only and most effective treatment way currently. The surgical methods involve hemilaminectomy, en block vertebral resection, intra- capsular resection, and microsurgery techniques. The surgical consequences are usually good with satisfactory overall clinical outcomes. A reasonable surgical plan should be made based on various factors, such as different imaging manifestations, tumor invasion, functional needs, and stability after cervical surgery.