半椎板入路显微治疗椎管肿瘤

【目的】探讨单侧半椎板入路在显微手术治疗椎管内髓外硬膜下肿瘤中的应用。【方法】经单侧半椎板入路显微手术切除52例椎管内髓外硬膜下肿瘤，其中神经鞘瘤39例，脊膜瘤9例，神经纤维瘤4例。肿瘤位于颈段11例，胸段26例，腰段15例，其中哑铃型肿瘤6例。【结果]52例肿瘤均全切除，患者术后早期下床活动，恢复快。术后均未出现新的神经功能损害症状，长期随访症状和体征明显好转或消失，未出现手术并发症和脊柱畸形。【结论】经单侧半椎板入路结合显微神经外科技术，手术创伤小，对脊椎后柱结构破坏少，有利于脊柱的稳定性，对椎管髓外硬膜下肿瘤的治疗是良好的适应证。

Hemilaminectomy Approach for Microsurgical Treatment of Spinal Canal Tumor

[Objective] To explore the application of unilateral hemilaminectomy approach in microsurgical treatment of spinal intradural extramedullary tumor. [Methods] Totally 52 patients with spinal intradural extramedullary tumor including 39 schwannomas, 9 spinal meningiomas and 4 neurofibromas underwent microsurgical resection through unilateral hemilaminectomy approach. Among all cases, 11 cases were cervical, and 26 cases were thoracic, and 15 cases were lumbar in which 6 cases were dumbbell-shaped. [Results] All the 52 tumors were totally excised. The patients got the early out-of-bed activity and rapid recovery. No new neurological symptom was found after operation. The symptoms and signs were obviously improved or disappeared during long-term follow-up. No operative complication and spinal deformity occurred. [Conclusion] Unilateral hemilaminectomy approach combined with microsurgery has less operative wound and spinal posterior column damage, and is benefit for the stability of spine, so it is very appropriate for the treatment of spinal intradural extramedullary tumor.