两种椎板切除术在脊髓瘤治疗中的效果及对神经功能的影响

目的 探讨小切口单侧半椎板切除术、大切口全椎板切除术治疗脊髓瘤的临床效果及对患者神经功能的影响.方法 选取100例脊髓瘤患者的临床资料进行回顾性分析,其中,50例患者采用小切口单侧半椎板切除术治疗(小切口组),50例患者采用大切口全椎板切除术治疗(大切口组),对比两组患者的手术时间、出血量、下地时间、住院时间等围手术期指标及脊髓神经功能指标.结果 小切口组患者的手术时间与大切口组患者比较,差异无统计学意义(P﹥0.05),出血量、下地时间、住院时间均明显低于大切口组患者(P﹤0.01);术前、术后,小切口组与大切口组患者的脊髓ASIA功能分级、JOA评分比较,差异均无统计学意义(P﹥0.05);术后,小切口组与大切口组患者的脊髓ASIA功能分级、JOA评分较本组术前均明显提高(P﹤0.01).讨论 小切口单侧半椎板切除术、大切口全椎板切除术治疗脊髓瘤的效果相似,但小切口单侧半椎板切除术具有手术创伤更小,术后恢复更快的优势.

Effect of two options of laminectomy in the treatment of spinal cord tumors and the impact on neurological function of patients

Objective To investigate the clinical effect of small incision unilateral hemilaminectomy and large inci-sion laminectomy in the treatment of spinal cord tumors and the effects on neurological function.Method The clinical data of 100 patients with spinal cord tumors were retrospectively analyzed.Among them,50 cases were treated by small incision unilateral hemilaminectomy(small incision group),while another 50 patients were administered with large inci-sion laminectomy(large incision group),and the operative time,blood loss,time to ambulation,and hospital stay,as well as the neurological functions were compared between the two groups.Result There was no significant difference in the operative time between the small incision group and the large incision group(P>0.05),the blood loss,time to ambulation and hospital stay were less in small incision group than those in the large incision group(P<0.01);there was no signifi-cant difference between the ASIA function classification and the JOA score of the spinal cord in the two groups before and after surgery(P>0.05);while both were improved after surgery in patients of the two groups(P<0.01).Conclusion A comparable clinical effect is observed for patients treated by small incision unilateral hemilaminectomy or large incision laminectomy for spinal cord tumors,but small incision unilateral hemilaminectomy has the advantage of minor surgical wound and faster postoperative recovery.