单侧半椎板入路手术治疗椎管内髓外硬膜下肿瘤的疗效分析

目的 探讨单侧半椎板入路手术切除椎管内髓外硬膜下肿瘤的疗效。方法 回顾性分析2017年1月至2021年6月经单侧半椎板入路手术切除的22例椎管内髓外硬膜下肿瘤的临床资料。结果 肿瘤位于颈段4例，胸段11例，腰段7例。22例肿瘤均全切除，术后病理示神经鞘瘤15例、脊膜瘤6例、蛛网膜囊肿1例。术后随访6个月~5年，与术前相比，出院时美国脊髓损伤协会（ASIA）分级明显改善（P<0.05），疼痛视觉模拟量表（VAS）评分明显降低（P<0.05）；与出院时相比，末次随访ASIA分级进一步改善（P<0.05），VAS评分进一步降低（P<0.05）。随访期间，未出现新的神经功能缺损；MRI检查均未见肿瘤复发，脊柱X线检查未见脊柱畸形。结论 单侧半椎板入路手术切除椎管内髓外硬膜下肿瘤创伤小，对脊柱稳定性影响小，疗效良好。

Microsurgical resection of intraspinal extramedullary subdural tumors via unilateral hemilaminectomy

Objective To investigate the clinical efficacy of microsurgery through unilateral hemilaminectomy for the patients with intraspinal epidural tumor. Methods The clinical data of 22 patients with intraspinal epidural tumor treated by microsurgery through via unilateral hemilaminectomy from January 2017 to June 2021 were analyzed retrospectively. Results Four tumors were located in cervical segment of spinal canal, 11 in thoracic segment and 7 in lumbar segment. Total tumor resection was achieved in all the patients. Postoperative pathological results showed schwannomas in 15 patients, meningiomas in 6, and arachnoid cyst in 1. The clinical symptoms of all the patients were significantly improved after the operation. During the follow-up period (range, 6 months~5 years), there was no new neurological deficit, no tumor recurrence, and no spinal deformity. Conclusions For the patients with intraspinal epidural tumor, unilateral hemilaminectomy has the advantages of small trauma and light influence on spinal stability. Unilateral hemilaminectomy is the first choice for most intraspinal epidural tumors.