半椎板入路显微手术治疗硬脊膜动静脉瘘的疗效分析

Microsurgery through hemilaminectomy approach for spinal dural arteriovenous fistulas

目的探讨采用半椎板入路显微手术治疗硬脊膜动静脉瘘的效果。方法回顾性分析2018年1月至2022年1月经半椎板入路显微手术治疗的12例硬脊膜动静脉瘘的临床资料。结果12例均为单一瘘口,其中瘘口位于胸段10例,腰段2例。顺利夹闭瘘口,无脑脊液漏,未发生切口及中枢神经系统感染。术后随访6个月,12例症状均缓解;术后Aminoff-Logue残疾量表评分[(3.9±1.6)分]较术前[(6.6±2.1)分]明显改善(P<0.05);术后X线检查未发现脊柱不稳定情况。结论半椎板入路显微手术治疗硬脊膜动静脉瘘,瘘口封闭效果好,不易复发,对脊柱稳定性影响小。

Objective To investigate the clinical efficacy of microsurgery through hemilaminectomy approach for the patients with spinal dural arteriovenous fistula(SDAVF).Methods The clinical data of 12 patients with SDAVF who were treated by microsurgery through hemilaminectomy approach from January 2018 to January 2022 were retrospectively analyzed.Results All the 12 patients had single fistula,of which 10 fistulae were located in the thoracic segment and 2 in the lumbar segment.The fistulas were clipped successfully in all the patients.There was no cerebrospinal fluid leakage,incision infection or central nervous system infection.The follow-up(6 months)showed relief of symptoms in all the patients.Postoperative Aminoff-Logue Disability Scale score[(3.9±1.6)points]was significantly lower than preoperative score[(6.6±2.1)points;P<0.05].Postoperative radiography showed no spinal instability.Conclusions Microsurgery through hemilaminectomy approach can obtain good outcomes in the patients with SDAVF,which can completely clipped the fistulas,is not easy to relapse,and has little influence on the spinal stability.