半椎板入路显微手术治疗椎管内髓外占位性病变的临床研究  

Clinical research on microsurgery via hemilaminectomy approach for intramedullary occupying lesions in the spinal canal

作　　者：孔世奇[1] 李智敏[2] 王天宇[2] 尹振明[2] 高俊[2] 李永宁[2] 王振海[1] 

机构地区：[1]邢台市人民医院神经外三科,054031 [2]中国医学科学院北京协和医学院北京协和医院神经外科,100730

出　　处：《中国微侵袭神经外科杂志》2016年第4期160-162,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨半椎板入路显微手术治疗椎管内髓外占位性病变的临床疗效。方法回顾性分析应用半椎板入路显微手术治疗20例椎管内髓外占位性病变病人的临床资料。结果病变完全切除17例,部分切除3例,术中出血量平均80 ml。术后病人临床症状改善16例,无变化4例。围手术期无死亡病例、无并发症发生。病理证实：神经鞘瘤9例,脊膜瘤6例,脱落椎间盘组织2例,蛛网膜囊肿1例,肠源性囊肿1例,血管瘤1例。术后住院时间平均6 d。随访3~18个月,影像学检查未发现肿瘤复发,未发现脊柱不稳定。结论应用半椎板入路显微手术治疗椎管内髓外占位性病变,具有手术创伤小、保持脊柱稳定性、病人康复快的优势,值得临床推广应用。Objective To investigate the clinical efficacy of microsurgery via hemilaminectomy approachfor removal of intramedullary occupying lesions in the spinal canal. Methods Clinical data of 20 patients with intramedullary occupying lesions in the spinal canal and received microsurgery via hemilaminectomy approach were analyzed retrospectively. Results The occupying lesions were totally removed in 17 patients and partially removed in 3. The average volume of bleeding was 80 ml during the operation. The clinical symptoms were alleviated in 16 patients and stable in 4. There was no death and complication in the perioperative period. The diagnosis was established by postoperative pathological analysis, including schwannoma 9, spinal meningioma 6, shedding of intervertebral disc tissue 2, arachnoid cyst 1, enterogenous cyst 1 and hemagioma 1. The average hospital stay was 6 days. All the patients were followed up for 3 to 18 months, and there was no tumor relapse and no spinal instability by imaging examination. Conclusion Hemilaminectomy microsurgery for the removal of occupying lesions in the spinal canal has such advantages as minimal invasion, protection of spinal stability and quick recover, which is worth wider application.

关 键 词：入路 半椎板 椎管 病变 占位 显微外科手术 

分 类 号：R651[医药卫生—外科学]