半椎板入路椎管内肿瘤显微切除术

目的探讨经一侧半椎板入路在显微切除椎管肿瘤中的应用。方法经一侧半椎板显微切除69例椎管内肿瘤，其中神经鞘瘤31例，脊膜瘤19例，上皮样囊肿6例，蛛网膜囊肿4例，海绵状瘤3例，室管膜瘤2例，星形细胞瘤2例，髓母细胞瘤椎管转移2例。肿瘤位于颈段19例，胸段34例，腰段16例。结果除2例髓内星形细胞瘤外，其余肿瘤均获全切，术后2周即可下床活动，随访期内（2-48个月）症状和体征均明显改善，无手术并发症和脊柱畸形。结论经一侧半椎板入路能够最大程度保留脊柱后部的肌肉、韧带和骨结构，有利于脊柱稳定性，具有手术创伤小、安全、卧床时间短等优点。

The unilateral hemilaminectomy approach for the microsurgical treatment of the spinal cord tumors

Objective To study the unilateral hemilaminectomy approach for the microsurgical treatment of the spinal cord tumors. Methods 69 patients with spinal cord tumors were operated by microsurgical treatment through the unilateral hemilaminectomy at our hospital, including 31 schwannomas, 19 meningiomas, 6 epidermoid cysts , 4 arachnoid cysts, 3 cavernous angiomas, 2 astrocytomas and 2 metastatic tumors from brain medulloblastoma. In which 19 were cervical, 34 were thoracic and 17 lumbar. Results All the tumors were totally excised except 2 astrocytomas. The patients who were operated can move after two weeks. The symptoms and signs were obviously improved without complication of surgery and spinal abnormality. Conclusions Microsurgery through unilateral hemilaminectomy which can hold the muscle, ligament and bone structure of post - spine at most, profits the stability of spina and has other merits, including slight surgery trauma and safety and short time of bed rest. So this method is worth promoting and appling.