单侧部分半椎板入路显微手术治疗脊柱脊髓肿瘤

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英文篇名：Microsurgical treatment for spinal tumors via unilateral partial hemilaminectomy approach 作者：侯哲 ; 张洪兵 ; 王浩 ; 梁聪 ; 盖起飞 ; 范涛 英文作者：Hou Zhe;Zhang Hongbing;Wang Hao;Liang Cong;Gai Qifei;Fan Tao;Department of Neurosurgery, Beijing Luhe Hospital, Capital Medical University;Department of Spine Center, Sanbo Brain Hospital, Capital Medical University; 关键词：脊髓肿瘤 ; 入路 ; 部分半椎板 ; 监测 ; 运动和体感诱发电位 ; 显微外科手术 英文关键词：spinal cord neoplasms;;approach,unilateral partial hemilaminectomy;;motor and somatosensory evoked potential monitoring;;microsurgery 中文刊名：ZWQX 英文刊名：Chinese Journal of Minimally Invasive Neurosurgery 机构：首都医科大学附属北京潞河医院神经外科;首都医科大学三博脑科医院脊髓脊柱外科中心; 出版日期：2019-06-19 11:57 出版单位：中国微侵袭神经外科杂志 年：2019 期：v.24;No.229 语种：中文; 页：ZWQX201906006 页数：3 CN：06 ISSN：44-1459/R 分类号：17-19

摘要

目的探讨采用单侧部分半椎板入路显微手术切除脊髓肿瘤。方法回顾性分析45例单侧部分半椎板入路显微手术切除脊髓肿瘤病人的临床资料,术中均行运动和体感诱发电位监测。结果 45例肿瘤均达全切除,术后病理:神经鞘瘤15例,脊膜瘤17例,神经纤维瘤9例,肠源性囊肿3例,海绵状血管瘤1例。术后随访6～24个月,无肿瘤复发,无脊柱失稳病例。结论偏向一侧的椎板节段间脊髓肿瘤及部分椎管内外沟通性肿瘤可选用单侧部分半椎板入路手术,该术式能够充分显露肿瘤,且保留椎板后弓的完整性,对脊柱稳定性影响较小。
        Objective To explore the microsurgical treatment for the spinal tumors via unilateral partial hemilaminectomy approach.Methods Clinical data of 45 patients with spinal tumors undergoing microsurgical treatment via unilateral partial hemilaminectomy approach were retrospectively analyzed, and all the patients received motor and somatosensory evoked potential monitoring in the surgery. Results All the tumors were totally removed. The postoperative patholgy showed schwannomas in 15 patients, meningioma in17, neurofibroma in 9, neurenteric cyst in 3 and cavernoma in 1. All the patients were followed up from 6 to 24 months after the operation, no tumor recurrence or spinal instability occurred. Conclusions Unilateral partial hemilaminectomy aprroach is suitable for lateral growth spinal tumors between two vertebral plates and intra-and extra-spinal communicating tumors. This approach can fully expose the tumors and preserve the integrity of the posterior laminar arch, thus having little impact on the stability of the spine.

引文

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