Preliminary Scoring And Classification Method And Surgery Experience Of Primary Cervical Spinal Dumbbell Tumors

Objective:To investigate the value of clinical use of a classification method which was established in the guiding of multi-slice CT angiography(MSCTA)combined with volume rendering technology(VRT)as well as the evaluation of postoperative complication and prognosis.Methods:1.A retrospective analysis of 48 patients with primary dumbbell tumor of cervical spine who underwent surgery in the Department of Neurology,China-Japan Union Hospital of Jilin University from January 2010 to May 2018 was carried out.According to their preoperative MRIs and MSCTA-VRT images and the distances from spinal canal center to other structures on MRI,as well as surgery plan,assessment of surgery risks and judgement of complications and prognosis,we chose four criteria that are relationships among cervical dumbbell tumors and dura,vertebral artery,intervertebral spaces,and the distance from the center of vertebral canal to the outmost point of tumor to establish a novel scoring and classification method of primary cervical dumbbell tumors.Then we evaluated its clinical application.2.The normal cervical spinal MRI results of 80 patients in China-Japan Union Hospital from January 2017 to May 2018 were randomly selected.We measured the distances of spinal canal center to the outer edge of vertebral artery,the outer edge of the intervertebral joint and intervertebral foramen,each distance was measured twice and then we got the average.Result:1.According to this classification method,16 of 48 patients were stage I,19 cases were stage II,11 cases were stage III,and 2 cases were stage IV.All patients were treated by optimal surgical approaches,47 cases achieves total removal of the tumors,and 1 case achieved subtotal removal.We effectively avoided unnecessary damages of spinal cord,nerve and blood vessels during the procedure,and reduced intraoperative bleeding,and maintained cervical stability and flexibility.2.The measuring results of 80 cases showed that the distance from the center of the spinal canal to the lateral edge of the intervertebral joint was mostly 2.6 cm,the distance from the outer edge of the vertebral artery to spinal canal center was mostly2.3 cm,and the distance from the intervertebral foramen to spinal canal center was mostly 1.5 cm.Conclusion:This scoring and classification method can be a good guidance to the treatment of primary benign cervical dumbbell tumors.In the guiding of this method,important information can be provided for preoperative tactics to reduce surgical trauma and complications.At the same time,the scores can directly reflect the difficulty of surgery,the possibility of postoperative complications and guide the judgement of prognosis.