半椎板入路在椎管病变手术中的应用

Unilateral hemilaminectomy for microsurgical treatment of spinal cord tumors

目的经全椎板入路,对脊柱破坏性大,影响其稳定性。文中探讨半椎板入路切除椎管内肿瘤的临床经验。方法回顾性分析利用半椎板入路切除椎管内肿瘤患者23例,其中神经鞘瘤13例、脊膜瘤7例、肠源性囊肿2例、腰骶管表皮样囊肿1例。磨钻磨除同侧半椎板,采用显微外科技术切除肿瘤。结果21例患者肿瘤全切除,2例次全切除。3例患者因肿瘤所属的神经根切断出现相应肌肉运动障碍,随访6个月,其中2例完全恢复,另1例恢复不完全。其他患者未见术后脊柱畸形或活动障碍。结论对于椎管内髓外的良性肿瘤,小切口半椎板技术手术创伤小,手术后恢复快。

Objective Total laminectomy is unstable and destructive to the vertebral column.This article was to evaluate the advantages and disadvantages of unilateral hemilaminectomy for the removal of intraspinal tumors.Methods We retrospectively studied 23 cases of intraspinal tumor treated by unilateral hemilamilectomy,of which 13 were schwannoma,7 spinal meningioma,2 enterogenous cyst,and 1 epidermoid cyst.Results The tumors were totally resected in 21 cases and partially resected in the other 2.Muscular motor disturbance occurred in 3 of the cases because of the cutoff of the tumor-related nerve root,of which 2 were completely and 1 partially recovered after 6 months.No postoperative spinal or motor abnormalities were observed in any other cases.Conclusion For the removal of intraspinal tumors,unilateal hemilamilectomy has the advantages of minimal invasiveness and faster recovery.