半椎板入路显微手术切除椎管内肿瘤的方法及效果评价

Microsurgical resection of intraspinal tumors via hemilaminectomy: methods and their clinical effects

摘要:

目的 探讨半椎板入路显微切除治疗椎管内肿瘤的手术方法及效果。方法 回顾性分析2013年1月～2016年4月我院89例经半椎板入路微创显微手术治疗椎管内肿瘤的临床资料。半侧椎板开窗从1个节段到9个节段不等，开骨窗宽约1.0～1.5cm，通过患者手术前后Frankel分级评价手术效果。结果 肿瘤全切除85例，4例近全切除，手术均不同程度改善了所有病人的神经功能，随访5～24个月，行颈、胸、腰椎MRI及X-线或CT复查，未见脊柱畸形，且稳定性良好，1例脊膜瘤复发。结论 半椎板入路手术创伤小，术后恢复快，可最大限度维持脊柱稳定性，适合于椎管内大部分肿瘤的切除。

Abstract:

Objective To investigate the surgical methods for microsurgical resection of intraspinal tumors via hemilaminectomy and their clinical effects.Methods A retrospective analysis was performed for the clinical data of 89 patients with intraspinal tumors who underwent microsurgical resection via hemilaminectomy in our hospital from January 2013 to April 2016. The bone window for hemilaminectomy was 1.0-1.5 cm in size and ranged from 1 to 9 segments. The surgical effect was evaluated based on the Frankel grade before and after surgery.Results Of all patients, 85 achieved total resection of tumors and 4 had near-total resection. There were varying degrees of improvement in neurological function after surgery. The patients were followed up for 5-24 months; cervical/thoracic/lumbar MRI and X-ray or CT showed no spinal deformity and there was good safety; one patient experienced recurrence of spinal meningioma.Conclusions Hemilaminectomy has the advantages of little surgical trauma and fast postoperative recovery and can best maintain spinal stability. Therefore, it can be used for resection of intraspinal tumors.