半椎板入路治疗硬脊膜动静脉瘘  

Treatment of spinal dural arteriovenous fistulas by hemilaminectomy approach

作　　者：王斌[1] 许天助 那世杰[2] 刘涛[2] 杨天明[1] Wang Bin;Xu Tianzhu;Na Shijie;Liu Tao;Yang Tianmin(Department of Neurosurgery,BenQ Medical Center,the Affiliated BenQ Hospital of Nanjing Medical University,Nanjing,Jiangsu 210019,China;Department of Neurosurgery,Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu 210008,China)

机构地区：[1]南京医科大学附属明基医院神经外科,210019 [2]南京大学医学院附属鼓楼医院神经外科,210008

出　　处：《中国微侵袭神经外科杂志》2020年第8期348-350,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：南京市卫计委课题(编号:YKK17093)

摘　　要：目的探讨半椎板入路在治疗硬脊膜动静脉瘘(spinal dural arteriovenous fistulas,SDAVF)的应用价值。方法回顾性分析15例经脊髓MRI和血管造影确诊的SDAVF病例资料,均为单一瘘口供血。病灶位于胸段9例,腰段6例,均经半椎板入路行显微手术夹闭瘘口。结果9例在复合手术室完成,6例在常规手术室完成。术后14例行脊髓MRI复查示脊髓周边的血管流空影消失。10例行脊髓血管造影复查示瘘口消失。15例随访3~36个月,平均(16.8±8.1)个月,其中4例病人症状消失,6例病人症状好转,5例病人症状改善不明显。结论半椎板入路显微手术治疗SDAVF安全、微创、有效。Objective To explore the application value of treatment of spinal dural arteriovenous fistulas(SDAVF)by hemilaminectomy approach.Methods The clinical data of 15 patients with SDAVF diagnosed by spinal cord MRI and angiography were analyzed retrospectively.All the fistulas were supplied by a single fistula.The lesions were located in the thoracic segment in 9 cases and the lumbar segment in 6.The fistula was cut off by microsurgery through the hemilaminectomy approach.Results Nine patients were performed of the microsurgery in hybrid operating room and 6 in the conventional operating room.Postoperative spinal cord MRI showed perimedullary tortuous flow voids disappeared in 14 patients.Disappearance of the SDAVF fistula was confirmed by postoperative angiography in 10 patients.Fifteen patients were followed up for 3-36 months,showing recovery in 4,improvment in 6,no improvment in 5.Conclusion Microsurgery via hemilaminectomy approach is safe,minimally invasive and effective for the treatment of SDAVF.

关 键 词：动静脉瘘 硬脊膜 半椎板入路 神经外科手术 

分 类 号：R743.4[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]