部分半椎板与半椎板入路显微切除椎管内神经鞘瘤的疗效比较

Efficacy comparison of hemi-semi-laminectomy and hemilaminectomy approach for microsurgical treatment of spinal schwannomas

目的:比较经部分半椎板入路与半椎板入路治疗椎管内神经鞘瘤的临床疗效及安全性。方法:选择24例经部分半椎板入路显微手术治疗的椎管内神经鞘瘤患者,以及同期采用半椎板入路治疗的30例椎管内神经鞘瘤患者。比较两组患者手术时间、术中失血量、术后并发症及脊柱稳定性、住院时间及费用的差异。结果:两组患者肿瘤均获全切除,患者症状和体征术后均明显改善。与半椎板入路组相比,部分半椎板入路组手术时间短、术中失血量少、住院时间短、住院费用低,差异有统计学意义(P<0.05)。两组患者术后均无明显并发症与脊柱畸形发生,差异无统计学意义。结论:经部分半椎板入路较半椎板入路创伤更小,不增加手术风险与并发症,用于治疗椎板节段间椎管内神经鞘瘤安全而有效。

Objective：To compare the clinical effect between hemi-semi-laminectomy and hemilaminectomy approach for treatment of spinal schwannomas. Methods： Clinical data of patients with spinal schwannomas who underwent microsurgical treatment were retrospectively analyzed,among them,24 cases for hemi-semi-laminectomy approach and 30 cases for hemilaminectomy approach.The duration of operation,intraoperative blood loss,postoperative complications,spinal stability,stay time and costs of hospitalization were compared between two groups.Results：The tumors were totally removed,and the symptoms and signs were improved significantly after operation in both groups.Compared with hemilaminectomy approach group,hemi-semi-laminectomy approach group had shorter operation duration,less intraoperative blood loss,shorter hospitalization stay and lower costs（all P〈0.05）. However,there were no significant differences in incidences of complications or spinal deformity between two groups.Conclusions：Hemi-semi-laminectomy approach can achieve a further reduction in iatrogenic trauma compared with hemilaminectomy approach without increasing surgical risk and incidences of complications,which is a safe and effective approach for microsurgical treatment of spinal schwannomas between two vertebral plates.