超声乳化技术辅助显微手术切除脊髓腹侧及腹外侧神经鞘瘤

Utrasonic technology-assited microsurgery resection of ventral or ventrolateral spinal schwannomas

目的探讨超声乳化技术在椎管内脊髓腹侧及腹外侧神经鞘瘤切除术中的应用价值。方法应用日本SONOPETMODELUST-2001超声乳化吸引系统，采用后入路方法，结合显微手术切除40例椎管内脊髓腹侧及腹外侧神经鞘瘤。结果术中全部病例均在超声乳化技术辅助下行肿瘤全切除，术中视野暴露清晰，椎板切除范围可控，无继发损伤发生，出血量为50～150mL，平均出血量70mL，术中均未输血，术后病理诊断证实为神经鞘瘤，术前后MR影像展示证实肿瘤全切除，术后所有患者神经功能均有明显恢复，住院天数8～12d，平均10d，随访3月～4年，无脊柱不稳、根痛、复发等现象。结论后入路椎管内脊髓腹侧及腹外侧神经鞘瘤采用超声乳化技术辅助显微手术技术切除，是一种十分有效而安全的手术方法，特别是在骨窗形成和肿瘤全切除上，无物理性挤压、旋转撕脱伤及高温灼伤，且减少术中出血量，确保脊柱的稳定，避免术后疼痛，能充分达到微创的手术效果。

Objective To explore the application of utrasonic technology-assited microsurgery resection of ventral or ventrolateral spinal schwannomas. Methods Forty patients with ventral or ventrolateral spinal sehwannomas were treated by CUSA-assited microsurgery. Results The tumors were totally resectcd successfully acompanied by minimal blood loss and adjacent structures could avoid damaged. Preoperative and postoperative magnetic resonance imaging demonstrated complete resection in all cases. Neurological functions had good recovery. With follow-up of 3 months to 3 years, there was no instability of the spine or any recurrence. Conclusion utrasonic technology-assited mierosurgery resection of ventral or ventrolateral spinal schwannomas by posterior approach appears a safe, efficient mini-invasive surgical approach, without mechanical or heat injury.