通道辅助显微镜下Key-hole技术治疗椎管内髓外硬膜下肿瘤  

Treatment of Intraspinal Extramedullary Subdural Tumors with Key-hole Technique under Channel Assisted Microscope

作　　者：徐军 杜磊 刘阳 夏鹤春 何柄环 向清波 孙涛 XU Jun;DU Lei;LIU Yang;XIA Hechun;HE Binghuan;XIANG Qingbo;SUN Tao(Department of Neurosurgery,Hospital of Cardiovascular and Cerebrovascular Diseases,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Key Laboratory of Craniocerebral Diseases,Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院心脑血管病医院神经外科,银川750004 [2]宁夏医科大学颅脑疾病重点实验室,银川750004

出　　处：《宁夏医科大学学报》2021年第1期39-42,共4页Journal of Ningxia Medical University

摘　　要：目的探讨通道Key-hole技术在原发椎管内髓外硬膜下肿瘤切除中的可行性和安全性。方法回顾性分析宁夏医科大学总医院心脑血管病医院神经外科2018年3月至2019年11月就诊的31例采用通道辅助显微镜下切除的椎管内髓外硬膜下肿瘤手术患者临床资料。结果 31例患者椎管内肿瘤均全部切除,病理结果显示神经鞘瘤21例、脊膜瘤8例、皮样囊肿1例、肠源性囊肿1例,其中位于颈椎8例、胸椎17例、腰椎6例。术后1例患者症状加重,其他明显好转;5例术区积液;2例感染。术后5 d视觉疼痛模拟(VAS)评分为(2.4±0.3)分。术后1个月JOA评分平均提高至6.3分,随访3~15个月,无脊柱不稳或脊柱畸形发生。结论通道辅助显微镜下Key-hole技术进行椎管内髓外硬膜下肿瘤切除,创伤小、恢复快、不影响脊柱稳定性,手术安全可靠,值得在临床推广应用。Objective To investigate the feasibility and safety of microchannel in primary intraspinal subdural extramedullary tumor resection with Key-hole technique. Methods The clinical data of 31 patients with intraspinal subdural extramedullary tumor surgery in Neurosurgery Department of Cardio-cerebrovascular Disease Hospital of Ningxia Medical University from March 2018 to November 2019 were retrospectively analyzed. Results All 31 patients had tumors were removed,and the pathological results showed that there were 21 cases of schwannoma,8 cases of meningioma,1 case of dermoid cyst and 1 case of enterogenic cyst,including 8 cases of cervical spine,17 cases of thoracic vertebrae and 6 cases of lumbar vertebrae. After the operation,1 case was aggravated,and others were significantly improved. There were five cases of operation area effusion,2 cases of subarachnoid infection. The average score of visual pain simulation(VAS)was(2.4 ±0.3)at five days after the operation. JOA score increased by an average of 6.3 points one month after the operation,and there was no spinal instability or deformity during the follow-up from 3-15 months.Conclusion Microchannel assisted microscopy for intraspinal subdural extramedullary tumor resection is feasible,safe and reliable,and can be popularized in clinical practice.

关 键 词：通道 髓外硬膜下肿瘤 Key-hole技术 稳定性 

分 类 号：R739.4[医药卫生—肿瘤]