半椎板入路脊髓肿瘤切除后椎板再植26例临床分析

Clinical Analysis of 26 Cases of Unilateral Hemilaminectomy Approach Combined with Bone Replantation in the Microsurgical Treatment of the Spinal Cord Tumors

目的：探讨椎管重建在脊髓肿瘤显微切除中的应用价值。方法：采用半椎板入路显微切除脊髓肿瘤加切除骨再植26例，其中神经鞘瘤14例，脊膜瘤10例，蛛网膜囊肿2例，并随访3—18个月观察效果。结果：本组均行半椎板入路脊髓肿瘤切除椎板再植术，其中切除1个半椎板再植5例，2个半椎板再植18例，3个半椎板再植3例。患者术后2周即可下床活动，随访期内无椎管狭窄和脊柱畸形。结论：本术式创伤小，韧带破坏少，切下的椎板再植后基本恢复椎管解剖结构，有利于脊柱稳定性，值得临床推广。

Objective： To explore the importance of reconstruction of spinal canal during microsurgical treatment of spinal cord tumors. Methods ： Among 26 patients with the spinal cord tumors, 14 were schwannomas, 10 meninginmas and 2 arachnoid cysts. All cases were operated via unilateral hemilamineetomy combined with bone replantation and were followed up for 3 to 8 months. Results： All the patients underwent hemilaminectomy,including 5 cases of replantation with 1 hemilaminectomy;18 with 2 and 3 with 3. All the patients could walk 2 weeks after operation and no spinal stenosis and spinal deformity were found during the follow-up periods. Conclusion：Laminoplasty can improve the spinal stabilization by restoring spinal canal structures and remodeling spinal canal. The method is less-invasive,less-damaging to ligament and is worth promoting.