半椎板入路切除椎管内外哑铃型肿瘤

Hemilaminectomy Approach for Spinal Dumbbell-shaped Tumor Resection

目的探讨经半椎板入路切除椎管内外哑铃型肿瘤的手术技巧。方法回顾性分析2013年3月—2018年5月于中国医学科学院肿瘤医院神经外科治疗的26例椎管内外哑铃型肿瘤患者的临床资料。结果26例均采用了半椎板入路切除肿瘤,其中经后正中入路13例,经前侧方入路12例,前后联合入路分期手术1例;肿瘤全切除25例,次全切除1例。术后随访4~60个月,患者症状均明显缓解,无明显脊柱畸形发生。结论 大多数椎管内外哑铃型肿瘤能够经半椎板入路一期手术切除;与传统的全椎板手术方式相比,半椎板入路创伤较小,几乎不影响脊柱的稳定性。

Objective To investigate the surgical technique of the hemilaminectomy for theresection of spinal dumbbell-shaped tumors. Methods The clinical data of 26 adult patients with spinal dumbbell-shaped tumor surgically treated in Department of Neurosurgery, Cancer Hospital Chinese Academy of Medical Sciences from March 2013 to May 2018 were analyzed retrospectively. Results Hemilaminectomy was used in all patients to resect the tumor,including posterior median hemilaminectomy approach in 13 patients, anterior lateral hemilaminectomy approach in 12 and combined anterior and posterior approach in 1. Gross total resection was achieved in all but 1 patient in this group. The postoperative follow-up for 4 to 60 months showed neurological symptoms were significantly relieved without obviously spine instability. Conclusions Most spinal dumbbell-shaped tumors could be resected through a hemilaminectomy approach in single stage. Compared with traditional laminectomy, hemilaminectomy has less trauma and little impact on the spine stability.