椎板成形术在椎管内硬膜外囊肿切除术中的应用

Application of laminoplasty in spinal epidural cyst resection

目的 探讨椎板成形术在椎管内硬膜外蛛网膜囊肿（SEAC）外科治疗中的意义.方法 回顾性分析24例SEAC患者,患者分为非椎板成型组（A组）及椎板成型组（B组）.对比两组患者的手术时间、手术出血量、术前及术后患者JOA评分以及神经功能恢复率、术前及术后脊柱Kyphotic角度等.结果 B组的手术出血量为（111.1 ±48.6） ml,显著少于A组（513.3±131.6） ml（t=-8.755,P=0.000）.B组的手术时间为（45.4 ±5.3）min,显著短于A组（89.8±19.1）min（t=-8.443,P=0.000）.B组术后Kyphotic角度为6.8°±1.2°,显著小于A组10.1°±1.2°（t=-6.388,P=0.000）.而两组的术前Kyphotic角度、术前JOA评分、术后JOA评分和神经功能恢复率差异均无统计学意义（P＞0.05）.结论 以铣刀为基础的椎板成形术治疗SEAC,效果良好并能减少术后并发症,是安全、快捷的方法之一.

Objective To explore the significance of laminoplasty in the surgical treatment of spinal extradural arachnoid cyst （SEAC）.Methods 24 patients with SEAC,who were admitted and operated in the department of neurosurgery in Beijing Jishuitan hospital from May 2011 to June 2013 were retrospectively analyzed.According to the different surgical methods,all the patients were divided into two groups：non-laminoplasty group （group A） and laminoplasty group （group B）.The data of patients in each group involving operative time,blood loss,preoperative and postoperative JOA scores and neurological function recovery rate,preoperative and postoperative spine Kyphotic angle were analyzed retrospectively.Results The surgical bleeding in group B was （111.1 ± 48.6） ml,which was significantly less than the （513.3± 131.6）ml in group A （t =-8.755,P =0.000）.The operative duration time in group B was （45.4 ± 5.3） rman,which was significantly shorter than the （89.8 ± 19.1） min in group A （t =-8.443,P =0.000）.The group B Kyphotic angle of 6.8° ± 1.2°was significantly lower than the 10.1° ± 1.2°in group A （t =-6.388,P =0.000）.There was no statistical difference of the data of Kyphotic angle,preoperative JOA score,postoperative JOA score and the neurological recovery rate between two groups（t =-8.443,P 〉 0.05）.Conclusions Laminoplasty with craniotome was an effective and safe method with low recurrence for the treatment of SEAC.