椎间孔区病变微创手术的临床研究  

Minimal invasive neurosurgical treatment of intervertebral foraminal lesions

作　　者：刘藏[1] 侯瑞光[1] 陈旭[1] 王德江[2] 

机构地区：[1]首都医科大学附属友谊医院,北京100050 [2]首都医科大学附属天坛医院

出　　处：《中华医学杂志》2009年第3期160-163,共4页National Medical Journal of China

摘　　要：目的探讨微创手术治疗椎间孔区病变的疗效。方法回顾性分析2004年1月至2008年3月因椎间孔区病变行手术治疗的56例患者。对其术前情况、手术方法、手术时间、临床结果进行比较。结果共有56例患者因椎间孔区病变实施了手术，其中采用传统手术治疗病例25例（传统组），病变全切23例（92％），大部切除2例（8％），采用微创手术治疗者31例（微创组），病变全切28例（90．32％），大部切除2例（6．45％），1例（3．23％）硬脊膜下残留，未再次手术，两组比较差异无统计学意义（P〉0．05）。手术时间传统组平均为（18835）min，微创组为（14026）min，两者比较差异有统计学意义（P〈0．01）。随访3～48个月，两组患者均恢复正常生活工作，无复发者。结论椎间孔区微创手术创伤小，操作方便，对脊柱稳定性影响小，且费用低，但需定位准确，并熟悉其解剖关系。Objective To investigate the effectiveness of minimal invasive neurosurgery in treatment of intervertebral foraminal lesions. Method Fifty-six patients with intervertebral foraminal lesions were divided into 2 groups： minimal invasive neurosurgery group （MG group, n = 31 ） and traditional neurosurgery group （ TG group, n = 25 ）. Their pre-operational clinical conditions, methods of surgery, duration and effectiveness of operation were analyzed retrospectively. Follow-up was conducted for 3 - 48 months. Results Twenty-three of the 25 patients in the TG group （92%） had their lesions resected completely and 2 of the 31 patients （8%） underwent subtotal resection. In the MG group 28 of the 31 patients （90. 32% ） had their lesions reseeted completely, 2 （6. 45% ） underwent subtotal resection, and 1 patient （3. 23% ） showed epidural remains and did not receive further treatment. There was no significant difference in the effective rate between these 2 groups. The operation time of the TG group was （ 188 ± 35 ） minutes, significantly longer than that of the MG group [ （ 140 ±26） minutes, P 〈0.011] Follow-up showed that all patients resumed their normal life except the patient with epidural remains in the MG group, and no recurrent patient was found. Conclusion The minimal invasive neurosurgery is convenient, effective, and cheaper to treat intervertebral foraminal lesions. However, precise localization and intimate knowledge of the anatomy are important.

关 键 词：微创手术 肿瘤 脊柱疾病 

分 类 号：R686[医药卫生—骨科学]