半椎板入路在椎管内肿瘤切除术中的应用

Clinical study of hemilaminectomy in the treatment of intraspinal tumors

目的总结经半椎板入路在椎管内肿瘤手术中的应用。方法回顾性分析经半椎板入路显微手术切除椎管内肿瘤25例,其中神经鞘瘤18例,脊膜瘤6例,上皮样囊肿1例。肿瘤位于颈段16例,胸段7例,腰段2例。半椎板切除及肿瘤切除采用标准的显微外科技术。结果 24例手术操作顺利,1例因肿瘤较大,血供丰富,术中扩大行全椎板入路。25例肿瘤全切。其中神经鞘瘤18例,脊膜瘤6例,上皮样囊肿1例。随访未见术后脊柱畸形或活动障碍。结论半椎板入路椎管内肿瘤切除术创伤小,肿瘤切除顺利,手术后恢复快。但由于其暴露范围的限制,对血管畸形、髓内肿瘤及部分巨大肿瘤应用应慎重。

【Objective】To summarize the hemilaminectomy microsurgery in the application of intra-spinal canal tumor surgery. 【Methods】The 25 cases of intra-spinal tumor resectionwith hemilaminectomy microsurgery were retrospective analysed, of which 18 cases of schwannoma, 6 cases of meningioma, and 1 case of epithelial cyst. Tumors located in the cervical vertebraof 16 cases, 7 cases of thoracic and lumbar segments in 2 cases. 【Results】24cases of operation perfectly completed with hemilaminectomy microsurgery, 1 case of operationhas to expand to totallaminectomy because its larger size and rich blood supply. No postoperative spinal deformity or movement disorder in the follow-up.【Conclusions】hemilaminectomy microsurgeryis an effective wayin the spinal tumor resection with less trauma, speedy recovery. It also should be taken cautiously in patients with vascular malformation, intramedullary tumor and large intra-spinal tumor because of the limitation of its exposure.