The Clinical Manifestation And Treatment Of Tumors In Upper Cervical Spine

Objective To study the clinical manifestation, imaging characteristic, histopathological feature and the diagnosis of tumors in upper cervical spine, and approach the strategy of treatment and the key of surgery.Methods To analyze 33 cases of tumors in upper cervical spine which were confirmed by surgery and histopathology, and retrospect the literature for more in-depth understanding.Results Of all patients in this group, most of them with neck discomfort (17 cases), distal upper limb numbness (10 cases) or numbness with weakness (8 cases) as initial symptoms, with disease progression, ofen appear weak on one or both limbs (20 cases), numbness or hypoaesthesia (20 cases), neck discomfort (13 cases) or pathological reflex (13 cases), but urinary or fecal incontinence (3 cases) or respiratory paralysis (0 cases) are rare or defect, another one case with headache and convulsion as the first symptoms, and one case with the performance of Horner syndrome. MRI scan can be applied for diagnosis for all patients with the tumors in upper cervical spine. All of 33 patients underwent microsurgery treatment, of which,27 patients received total resection, and subtotal resection in 2 patients, partial resection in 4 patients. Histopathological examination showed:myoschwannoma (18 cases), spinal meningioma (6 cases), astrocytoma (3 cases) and ependymocytoma (3 cases); ganglioneuroma, malignant melanoma, arachnoid cyst are rare (1 case, respectively).Conclusion Most of the tumors in upper cervical spine were benign, but early symptoms were not typical, easy to misdiagnosis. MRI is the best examination methods. Microsurgery increase the total removal rate of tumor.High-dose corticosteroid, respiratory support and prevention of lung infection can help patients survive the peak period of spinal cord edema after surgery, which is the key to achieve better effect.