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Lipoma of cervical spinal canal in 1 case report of giant_61689

By Timothy Greene,2014-11-02 09:44
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Lipoma of cervical spinal canal in 1 case report of giant_61689

Lipoma of cervical spinal canal in 1 case report of giant

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     Study: Cheng Lu Wang Heng Zhong Wenjun Ruan Ziping

     [Keywords:] cervical spinal giant lipoma

     Undergraduate Office in 2006, treated a patient, female, 38 years old, Chuzhou people, the Department of the neck 3 months ago discomfort, neck pain activity was not addressed and checked, after accidentally during a physical examination cervical spine X ray showed: Tips C2 lamina abnormalities. then went to Shanghai Long March, Long Hai and Nanjing

    Military Region General Hospital for treatment, line-related

    examination of cervical spinal canal considered as occupying, lipoma may require hospitalization surgery patients after due to economic reasons, to our hospital and admitted to hospital.

    admission physical examination: Shen Qing, gas level, and obviously did not hear abnormal heart and lung, neck discomfort, no touch tenderness and percussion pain, both upper and lower limbs activities feelings are normal, normal muscle strength, physical reflection exist, pathological reflex was not elicited, urine normal. laboratory examination was normal. cervical CT and MRI examination revealed: C2 ~ 6 spinal placeholder (consider lipoma), clear boundary canal volume accounts for about 4 / 5, the spinal cord was

    compressed, the normal spinal cord signal.

     After admission in patients with normal preoperative examination and preparation, anesthesia and endotracheal intubation in the posterior laminectomy, tumor removal, and anterior interbody fusion with plate fixation. Surgery will remove the lower edge of lamina C2, C3 ~ 5 whole lamina C6 vertebral resection and removal of the upper edge, visible lamina thin, especially C2 lamina was, longitudinal incision dura mater, see the big fat kind of tumor, no obvious capsule, then to remove the tumor under the microscope, the ventral spinal cord tumor invasion and little visible as possible to remove the tumor (intramedullary still a little residual). protecting the spinal cord after washing the surgical field

and sutured, wound dressings, built-in drainage tube drainage.

    protection to patients with supine position after the neck and neck fixed, conventional surgical approach, C3 ~ 4, C4 ~ 5 intervertebral disc after removal of the implant to take their

    own iliac bone, and then use steel screws.

     Discussion

     Clinically, the tumor is often seen within the spinal canal, spinal tumor, while not within the spinal lesion itself, but if you do not timely detection and treatment, often involving

    the spine. Extramedullary benign tumors in the main, of which more common thoracic spinal canal, cervical canal is not rare. intraspinal tumors are usually schwannomas

    (neurofibromatosis), meningioma and spinal cord glioma common [1], lipoma is rare, especially in large lipoma is extremely

    rare. lipoma common in middle-aged, mostly of two types: one

    is slow-growing subcutaneous tumors often grow in groups, and another for the deep lipoma, usually a complete capsule [2].

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     Lipoma Treatment is usually surgical excision, if no significant effect and complications of surgery can be observed not because the lipoma liposarcoma is not changed. The growth of part of the special cases, if not treated may lead to serious consequences, it will laminectomy surgery, almost complete resection of the tumor. surgery should be noted that a clear diagnosis, as complete as possible removed. intraoperative sudden decompression, spinal cord edema caused by traction, after to dehydration, hormonal and vasodilation

    symptomatic treatment and treatment [3].

     Postoperative patients and the left lower limb numbness of left upper limb, and the remaining activities of both upper limbs and lower limbs, urine and all the normal, imaging and laboratory examination was normal .3 months after the follow-

    up, left arm and left leg was still numb, more patients slightly improved after six months and 1 year follow-up, the

    patient is still v. left arm numbness, left leg improved significantly, no other abnormalities, imaging studies

    revealed no obvious abnormalities.

     [References] [1] Cheng Anyuan, Liu article, Tian Xiao Yun, et al. Thoracolumbar spinal paraganglioma case report [J].

    Spine, 2006,26 (11): 738. [2] Xu Shaoting, FORCES, Xu Qin India. Practical Orthopedics [M]. 3rd ed. Beijing: People's Medical Publishing House, 2005:1551. [3] Zhao Dinglin. Spine surgery [M]. Shanghai: Shanghai Science and Technology Literature Publishing House, 1996,756 ? 757.

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