椎管内髓外硬膜下良性肿瘤不同手术方式临床效果比较的多中心研究  

Comparison of different surgical procedures for intraspinal extramedullary benign tumor:multi-center clinical trial.

作　　者：宗少晖[1] 韦波[2] 肖增明[1] 杨渊 李兵[4] 杨昆 李书振[5] 刘宏斌[6] 刘彦[7] 张冉[8] 熊春翔[9] 

机构地区：[1]广西医科大学第一附属医院脊柱骨病外科,南宁530021 [2]广西医科大学公共卫生学院,南宁530021 [3]广西骨伤医院骨科,南宁530021 [4]广西柳州市工人医院骨科,545005 [5]广西中医学院附属瑞康医院骨科,南宁530021 [6]北京大学深圳医院神经外科,广东深圳518036 [7]北京大学深圳医院病案室,广东深圳518036 [8]广西柳州市人民医院骨科,545006 [9]广西医科大学研究生学院,南宁530021

出　　处：《广东医学》2011年第20期2658-2661,共4页Guangdong Medical Journal

基　　金：广西医科大学博士后科研基金资助项目(编号:308083)

摘　　要：目的探讨手术治疗椎管内髓外硬膜下良性肿瘤的手术疗效和治疗策略。方法对151例椎管内髓外硬膜下良性肿瘤患者进行前瞻性多中心临床对照研究,手术方式分为:全椎板切除+肿瘤显微摘除术、半椎板切除+肿瘤摘除术、全椎板切除+肿瘤摘除+椎弓根螺钉内固定术、全椎板切除+肿瘤摘除术。以肿瘤所在部位:颈段、胸段、腰骶段分别对患者肿瘤全切除率、手术时间、术中出血量、手术并发症、住院时间、住院总费用、视觉模拟评分(VAS),日本矫形外科协会(JOA)评分进行评价。结果椎管内髓外硬膜下良性肿瘤的手术方式在颈段采取半椎板切除+肿瘤摘除术,在胸段采取全椎板切除+肿瘤显微摘除术,在腰骶段采用全椎板切除+肿瘤摘除+椎弓根螺钉内固定术较合适。结论进行椎管内髓外硬膜下良性肿瘤手术方式的选择时,应根据肿瘤所在部位的不同,采取不同的手术方式进行有效治疗。Objective To evaluate the operative efficacy and strategy for intraspinal extramedullary benign tumor. Methods 151 cases of benign intraspinal extramedullary tumor were enrolled for this multi - center clinical study. Surgical procedures included ： A, total laminectomy plus microscopic tumor enucleation ; B, semi - laminectomy plus tumor excision; C, total laminectomy, tumor excision plus vertebral arch pedicle screw fixation; D, total laminectomy plus tumor excision. According to the tumor site, patients were grouped into cervical, thoracic, lumbar and sacral group. Complete resection rate, operation time, blood loss, surgical complications, hospital stay, hospital charge, visual analog scale （ VAS）, and Japanese Orthopaedic Association （JOA） score were assessed for evaluation. Results According to this tri- al, the recommended surgical treatment for intraspinal extramedullary benign tumor in cervical, thoracic and lumbaosacral regions were semi - laminectomy plus tumor excision, total laminectomy plus microscopic tumor enucleation, and total laminectomy, tumor excision plus vertebral arch pedicle screw fixation, respectively. Conclusion Specific surgical procedures should be considered for intraspinal extramedullary benign tumors in different regions.

关 键 词：良性肿瘤 椎管内肿瘤 JOA评分 手术治疗 

分 类 号：R739.420.4[医药卫生—肿瘤]