摘要
目的探讨单开门椎管成形、重建椎管后部结构治疗颈椎管髓外硬膜内良性肿瘤的可行性及临床疗效。方法2001年1月至2013年1月，应用单开门椎管成形、重建椎管后部结构方法治疗颈椎管髓外硬膜内肿瘤87例，其中采用单开门掀起椎板、显微切除椎管内占位、椎板棘突复合体原位复位78例，单开门椎管扩大成形、切除肿瘤后微型钛板固定椎板重建椎管9例。结果随访12—58个月，平均26．3个月。椎板开门节段数2～5个，平均2．5个。平均手术时间92min（62—136min），术中平均失血80m1（50—260m1）。术后临床症状完全或大部分消失。所有病例均复查x线片未见脊椎失稳征象，63例复查CT显示复位的椎板棘突复合体无内陷移位，75例复查MRI显示颈椎管髓外硬膜内肿瘤无复发，无椎管狭窄、黄韧带和硬脊膜增厚。脊椎曲度的变化：颈椎曲度由术前的（17．8±8．4）°变为术后12个月时的（16．1±7．8）°，手术前后比较差异无统计学意义（P〉0．05）。结论单开门椎管成形术治疗颈椎管髓外硬膜内肿瘤，对肿瘤暴露及切除效果满意的同时，保存了一侧椎板的连续性，椎板棘突韧带复合体复位后恢复了脊椎的原有解剖结构，对脊椎的稳定性影响小，可避免椎板切除术后脊椎畸形的发生。
Objective To investigate the feasibility and clinical efficacy of single pen-door laminoplasly and reconstruction of the posterior structure of spinal canal for the treatment of cervical intradural extramedullary tumors. Methods From January 2001 to January 2013, 87 patients with cervical intradural cxtramedullary tumor were treated by using the single open-door laminoplasty, reconstruction of the spinal posterior structure method, and 78 of them were treated with the single open-door setting off lamina, microsnrgical resection of intraspinal occupying, lamina and spinous process complex in situ reduction, 9 were treated with single open-door laminoplasty and reconstruction of the spinal canal with mini titanium plate fixation after removal of the tumors. Results They were followed up for 12 to 58 months （ mean 26. 3 months）. The numbers of lamina open-door segments were 2 to 5 （mean 2. 5 ）. The mean operation time was 92 min （range 52-136 rain ）; the intraoperative mean blood loss was 80 ml （range 50-260 ml ）. The postoperative clinical symptoms of the patients disappeared completely or mostly. Postoperative X-ray examinations of all cases did not show the signs of spinal instability, CT scan of 53 cases revealed that spinous process-lamina complex of reduction did not have invagination and displacement. MRI of 75 cases showed that their cervical intradural extramedullary tumors did not have reemTence. No spinal canal stenosis, yellow ligament, and dura thickening were observed. The changes of spinal curvature： cervical curvature decreased from preoperative 17.8±8.4° to 15. 1 -±7.8° at 12 months after procedure. There was no significant difference between before procedm＇e and after procedure （P 〉 0. 05）. Conclusions Single open-door laminoplasty for the treatment of cervical intradural extramedullary tumor has satisfactory effect for tumor exposure and resection, at the same time; it saves the continuity of the lamina on one side. After spinous process-lamina complex of reduction, t
出处
《中华神经外科杂志》
CSCD
北大核心
2015年第9期928-931,共4页
Chinese Journal of Neurosurgery
关键词
椎管内肿瘤
显微手术
单开门椎板成形
Intraspinal tumor
Microsurgery
Single open-door laminoplasly
