部分半椎板入路微创手术切除腰椎椎管内髓外硬膜下肿瘤疗效分析

Partial hemi laminectomy approach for minimally invasive surgery for lumbar intraspinal extramedullary tumor

目的:探讨部分半椎板入路微创手术切除腰椎椎管内髓外硬膜下肿瘤的方法及疗效。方法:回顾性分析15例经一侧部分半椎板入路微创手术切除椎管内硬膜下肿瘤患者的临床疗效。结果:术后病理证实神经鞘瘤10例,脊膜瘤5例,均全部切除。所有患者术后早期可行肢体功能锻炼,无脑脊液漏等并发症出现。随访6～36个月,所有患者未出现脊柱畸形或不稳定,无病变复发。结论:经部分半椎板微创入路手术切除腰椎椎管内肿瘤能最大限度保护脊柱的肌肉韧带附着点及后柱的完整性,安全、创伤小。

Objective:To investigate the method and effect of partial hemilaminectomy for lumbar spinal extramedullary subdural tumors.Methods:A retrospective analysis on 15 cases of spinal canal subdural tumors treated by minimally invasive surgery via a partial unilateral hemilaminectomy approach was performed.Results:Postoperative pathology confirmed 10 cases of schwannoma and 5 cases of meningioma,all were excised.All patients were able to perform functional exercises at the early stage after operation,and no complications such as cerebrospinal fluid leakage occurred.All patients were followed up for 6~36 months without spinal deformity or instability and no recurrence.Conclusion:Minimally invasive partial hemilaminectomy for lumbar intraspinal tumors can protect the integrity of the muscular ligament attachment and posterior column of the spine to the greatest extent,and it is safe and minimally invasive.