半椎板入路显微镜下切除椎管内肿瘤疗效分析

The effect of Hemi laminectomy approach on resection of intraspinal tumors under microscope

目的探讨半椎板切除入路在椎管内肿瘤中的应用及其适应证。方法回顾性分析60例椎管内肿瘤病人的临床资料,其中髓外硬膜下肿瘤43例,髓外硬膜外27例,经部分半椎板入路为29例(部分组),经半椎板入路31例(椎板组)。收集患者手术时间、术中失血量、术后住院时间、术后肿瘤残留、术后脑脊液漏、术后复发等资料。应用SPSS 17.0软件进行统计分析。结果两组患者在手术时间、术中失血量、术后症状改善、术后脑脊液漏方面差别有统计学意义(P<0.05),通过数据显示,部分半椎板入路组,手术时间、术中失血量、术后症状改善、术后脑脊液漏方面明显优于半椎板入路组。两组在住院时间、术后残留、椎体不稳方面差别无统计学意义(P>0.05)。结论部分半椎板切除入路创伤小术、并发症少,可最大限度改善椎管内偏侧生长髓外良性肿瘤患者症状。

ObjectiveTo explore the application and indication of hemi laminectomy in spinal canal tumors.MethodsThe clinical data of 60 patients with intraspinal tumor were analyzed retrospectively,including 43 cases of extramedullary subdural tumor,27cases of extramedullary epidural,29 cases by partial laminectomy and 31 cases（laminectomy group）through semi laminectomy.The operative time,intraoperative blood loss,postoperative hospital stay,postoperative tumor residual,postoperative cerebrospinal fluid leakage and postoperative recurrence were collected.SPSS 17 software was used for statistical analysis.Results There were significant differences between the two groups in the operation time,the amount of blood loss,the improvement of the postoperative symptoms and the cerebrospinal fluid leakage（P〈0.05）.Through the data,the operative time,the amount of blood loss,the improvement of the postoperative symptoms and the leakage of cerebrospinal fluid after the operation were obviously superior to those of the semi laminectomy group.There was no significant difference in length of stay,postoperative residual and vertebral instability between two groups（P〈0.05）.Conclusionpartial hemi laminectomy has less trauma and fewer complications,which can improve the symptoms of spinal lateral growth benign extramedullary tumor.