椎旁肌肉间隙入路手术切除胸腰椎旁肿瘤的疗效分析  

Clinical efficacy of surgery through paravertebral muscle space approach(Wiltse approach)for patients with thoracolumbar paravertebral tumors

作　　者：李丹 罗冬冬 赵海林 胡骕 李佩恒 彭彪 LI Dan;LUO Dong-dong;ZHAO Hai-lin;HU Su;LI Pei-heng;PENG Biao(Department of Neurosurgery,Affiliated Cancer Hospital of Guangzhou Medical University,Guangzhou 510095,China)

机构地区：[1]广州医科大学附属肿瘤医院神经外科,广州510095

出　　处：《中国临床神经外科杂志》2023年第6期383-385,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨椎旁肌肉间隙入路手术切除胸腰椎旁肿瘤的临床疗效。方法回顾性分析2018年1月~2021年12月椎旁肌肉间隙入路手术切除的25例胸腰椎旁肿瘤的临床资料。结果胸椎椎旁肿瘤9例,腰椎椎旁肿瘤16例。25例肿瘤均完整切除,术后病理均为神经鞘瘤。手术出血量50~150 ml,平均80 ml;手术时间90~150 min,平均110 min;住院时间6~10 d,平均6.8 d。术后神经根放射性疼痛均缓解,无新发神经功能障碍,未出现腰椎术后综合征、蛛网膜下腔-胸膜瘘等并发症。术后随访3~48个月,椎体稳定性良好,未见肿瘤复发。结论椎旁肌肉间隙入路利用自然间隙完成肿瘤切除,疗效确切,术后并发症相对少,是一种安全的、有效的治疗胸腰椎旁肿瘤的方法。Objective To investigate the clinical effectiveness of surgery through paravertebral muscle space approach(Wiltse approach)for patients with thoracolumbar paravertebral tumors.Methods The clinical data of 25 patients with thoracolumbar paravertebral tumors who underwent surgery through Wiltse approach from January 2018 to December 2021 were retrospectively analyzed.Results Of 25 patients,9 suffered from thoracic paravertebral tumors and 16 suffered from lumbar paravertebral tumors.The tumors were completely resected in all the patients,and the postoperative pathological results showed neurinoma in all the patients.The intraoperative blood loss ranged from 50 ml to 150 ml,with an average of 80 ml.The operation time ranged from 90 min to 150 min,with an average of 110 min.The duration of hospitalization ranged from 6 days to 10 days,with an average of 6.8 days.The radiation pain of nerve root was relieved in all the patients after operation.There were no new nerve dysfunction,failed back surgery syndrome,or subarachnoid-pleural fistula.The follow-up(3~48 months)showed that the vertebral stability was good and no tumor recurred.Conclusions Surgery through paravertebral muscle space approach is a safe and effective method for the treatment of patients with thoracolumbar paravertebral tumors,which has many advantages such as accurate efficacy and relatively few postoperative complications.

关 键 词：椎旁肿瘤 胸椎 腰椎 肌肉间隙入路 显微手术 梨形 

分 类 号：R739.42[医药卫生—肿瘤] R651.11[医药卫生—临床医学]