部分半椎板与半椎板入路显微切除椎管内神经鞘瘤的疗效比较

目的:比较经部分半椎板入路与半椎板入路治疗椎管内神经鞘瘤的临床疗效及安全性。方法:选择24例经部分半椎板入路显微手术治疗的椎管内神经鞘瘤患者,以及同期采用半椎板入路治疗的30例椎管内神经鞘瘤患者。比较两组患者手术时间、术中失血量、术后并发症及脊柱稳定性、住院时间及费用的差异。结果:两组患者肿瘤均获全切除,患者症状和体征术后均明显改善。与半椎板入路组相比,部分半椎板入路组手术时间短、术中失血量少、住院时间短、住院费用低,差异有统计学意义(P0.05)。两组患者术后均无明显并发症与脊柱畸形发生,差异无统计学意义。结论:经部分半椎板入路较半椎板入路创伤更小,不增加手术风险与并发症,用于治疗椎板节段间椎管内神经鞘瘤安全而有效。

Efficacy Comparison of Hemi-Semi-Laminectomy and Hemilaminectomy Approach for the Microsurgical Treatment of Spinal Schwannomas

Objective: To compare the clinical effect between hemi-semi-laminectomy and hemilaminectomy approach for the treatment of Spinal Schwannomas. Methods: We retrospectively analyzed clinical data of patients with spinal schwannomas who underwent microsurgical treatment by either hemi-semi-laminectomy (n=24) or hemilaminectomy (n=30) approach during a period of October 2013 to February 2016 in our department. The operation time, intraoperative blood loss, complications, spinal stability, hospital stay and costs were compared. Results: All tumors were totally removed, and the symptoms and signs of patients were improved significantly after opreration in both groups. Compared with hemilaminectomy, hemi-semi-laminectomy approach had a statistically shorter operation time, less intraoperative blood loss, shorter hospital stay and lower costs (P<0.05). However, there was no significant difference between two groups in incidences of complications or spinal deformity(P>0.05). Conclusion: Hemi-semi-laminectomy can achieve a further reduction in iatrogenic trauma compared with hemilaminectomy and is a safe and effective approach for the microsurgical treatment of spinal schwannomas .