摘要
目的探讨微通道锁孔技术在椎管内肿瘤切除术中的应用价值。方法回顾性分析2017年2月~2018年9月34例椎管内髓外肿物的临床资料,包括腰骶椎肿瘤26例,颈椎肿瘤4例,胸椎肿瘤4例,长径0.5~2cm。采用显微镜下微通道锁孔技术联合半椎板切除或半侧椎板间开窗技术进行手术。结果半椎板切除25例,半侧椎板间开窗9例。肿瘤均获全切除,手术时间60~120min,平均87min。术后病理为神经鞘瘤26例,皮样囊肿、表皮样囊肿3例,单纯囊肿3例,脊膜瘤2例。术后无感染、脑脊液漏,无神经功能障碍加重。术后住院时间3~7d,平均5.4d。术后随访3~12个月,中位数6个月,未见脊柱不稳定或畸形,未见肿瘤复发或残留。按McCormick分级,均为Ⅰ级。结论两个节段以下的髓外肿瘤通过微通道技术可Ⅰ期全切。微通道技术有利于保留脊柱的正常结构和肌肉附着,有利于保持脊柱的完整性及稳定性。
Objective To explore the application of microchannel keyhole approach resection of intraspinal tumors.Methods The clinical features,imaging characteristics and surgical methods of 34 cases of intraspinal extramedullary tumor which were operated by microchannel hemilaminectomy or interlaminar fenestration from February 2017 to September 2018 were reviewed and analyzed. There were 26 cases of lumbosacral tumors,4 cases of cervical tumors and 4 cases of thoracic tumors,with a length of0. 5-2 cm. Results A total of 25 tumors were resected through hemilaminectomy and the other 9 tumors were resected through interlaminar fenestration. All the tumors were totally resected. The operation time was 60-120 min,with an average of 87 min.Postoperative pathological results included 26 cases of schwannoma,3 cases of dermoid cyst/epidermoid cyst,3 cases of simple cyst,and 2 cases of meningioma. No infection,cerebrospinal fluid leakage or neurological impairment was found after operation. The hospital stay was 3-7 d,with an average of 5. 4 d. The follow-up period ranged from 3 to 12 months( median,6 months). No spinal instability or deformity was found,and no recurrence or residual tumors were found. According to McCormick classification,the patients were all at stage Ⅰ. Conclusions The extramedullary tumors within two segments can be totally resected with microchannel keyhole approach. The procedure is in favor of preserving the normal structure and muscle attachment of the spine,and to maintaining the integrity and stability of the spine.
作者
林国中
马长城
吴超
Lin Guozhong;Ma Changcheng;Wu Chao(Department of Neurosurgery,Peking University Third Hospital,Beijing 100191,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2019年第6期494-497,共4页
Chinese Journal of Minimally Invasive Surgery
基金
首都临床特色应用研究项目(Z171100001017120)
关键词
微通道
半椎板切除术
椎板间开窗
椎管内肿瘤
稳定性
Microchannel
Hemilaminectomy
Interlaminar fenestration
Intraspinal tumor
Stability
