经皮微通道显微手术切除腰椎椎管内肿瘤的疗效

目的探讨经皮微通道显微镜下手术切除腰椎椎管内肿瘤的效果。方法回顾性分析2017年1月至2020年2月经皮微通道显微镜下手术治疗的37例腰椎椎管内肿瘤的临床资料。结果术后病理检查显示，神经鞘瘤20例，脊膜瘤4例，先天性囊肿6例，神经根囊肿5例，肠源性囊肿2例。术后症状均明显改善，未出现切口感染、神经根损伤、硬脊膜损伤、脑脊液漏、脊柱稳定性下降等并发症。术后1周复查腰椎MRI示椎管内肿瘤完全切除；术后6个月，复查MRI未见肿瘤复发。术后1周、3个月及6个月，疼痛视觉模拟量表评分、日本骨科协会评分、Oswestry功能障碍指数均明显改善（P<0.05）。结论经皮微通道显微镜下手术切除腰椎椎管内肿瘤，手术创伤小，具有良好的临床疗效。

Microsurgery though percutaneous microchannel for patients with lumbar intraspinal tumor

Objective To explore the clinical efficacy of microsurgery though percutaneous microchannel for the patients with lumbar intraspinal tumor (LIT). Methods The clinical data of 37 patients with LIT who underwent microsurgery though percutaneous microchannel from January 2017 to February 2020 were analyzed retrospectively. Results Postoperative pathological examination showed schwannomas in 20 patients, meningioma in 4, congenital cysts in 6, nerve root cysts in 5, and enterogenous cysts in 2. Symptoms were significantly improved in all the patients after the operation, and there were no postoperative complications such as wound infection, nerve root injury, dural injury, cerebrospinal fluid leakage, and decreased spinal stability. Re-examination of the lumbar spine MRI one week after the operation showed complete resection of the tumor in all the patients, and the re-examination of the MRI six months after the operation showed no tumor recurrence. At one week, three months and six months after operation, the visual analog scale score, the Japanese Orthopedic Association score, and the Oswestry dysfunction index were significantly improved (P<0.05). Conclusions Microsurgery though percutaneous microchannel, which has the advantages of minor surgical trauma and good clinical efficacy, is a good treatment method for the patients with LIT.