经一侧半椎板入路显微手术切除椎管内神经鞘瘤

Microsurgery through Unilateral Hemilaminectomy Approach for Intravertebral Canal Schwannomas

目的探讨经一侧半椎板入路在椎管内神经鞘瘤显微切除术中的应用。方法我们从1999年6月至2006年6月经一侧半椎板显微切除38例椎管内神经鞘瘤。其中肿瘤位于颈段13例,胸段19例,腰段6例。结果所有肿瘤均被全切除,病人术后2周即可下床活动,随访期内(2～48个月)患者的症状和体征均有明显改善,无手术并发症和脊柱畸形。结论经一侧半椎板入路能够最大程度保留脊柱后部的肌肉、韧带和骨结构,有利于脊柱的稳定性,具有手术创伤小、安全、卧床时间短等优点,值得进一步推广应用。

Objective To explore application of the unilateral hemilaminectomy approach to the microsurgery for intravertebral canal schwannomas. Methods Of 38 patients with intravertebral canal schwannomas, who underewent microsurgery through the unilateral hemilaminectony approach in our hospital from June 1999 to June 2006, 13 suffered from cervical intraventebral canal schannomas, 19 thoracic ones and 6 lumbar ones. Results All the tumors were totally removed. The patients could get out of bed 2 weeks after the operation. Following up from 2 to 48 months showed that the symptoms and signs were significantly improved and no complication of surgery and spinal abnormality occurred in all the patients. Conclusions The microsurgery through the unilateral hemilaminectomy approach, which can reserve the muscles, ligaments and bone structures at the back of spinal cord to the greatest extant, profits the spinal stability and has other merits including minimal trauma, operative salty and rapid recovery, is worth extensively applying.