单侧半椎板切除术在良性硬膜内脊柱肿瘤手术中的作用

Reha Can Köylü, M. Etli, C. Yaltırık
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摘要

目的:半椎板切除术可用于治疗硬膜内、髓外、髓内、硬膜外不同的占位性病变。在本研究中,我们研究了半椎板切除术在占据椎管的良性脊髓肿瘤中的作用。材料与方法:选取15例行半椎板切除术的脊柱肿瘤患者作为研究对象。选择半椎板切除术的方法是基于大小、侧边、受损伤节段的数量和可能的病理。研究对象的人口统计学,以及他们的手术报告、组织学结果、术前和术后图像以及随访信息。采用Frankel分级法评估入院时和随访期间的神经系统状况。结果:患者平均年龄48.4岁。其中男9例,女6例。根据肿瘤定位,其中颈3例,胸7例,腰5例。其中脑膜瘤4例,室管膜瘤6例,神经鞘瘤5例。1例患者比术前差,其余11例患者术后分级与术前相近。术后影像学显示所有患者均实现了大体全切除。结论:如果使用正确并有合理的学习曲线,有限的单侧半椎板切除术可以提供足够的进入硬膜囊的通道,允许安全切除几乎所有的脊髓硬膜内和硬膜外病变。因为它比标准的椎板切除术需要更少的时间,所以更适合老年人或高危患者。
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The Role of Unilateral Hemilaminectomy in Benign Intradural Spinal Tumor Surgery
Objective: Hemilaminectomy can be used to treat different space-occupying lesions, whether intradural, extramedullary, intramedullary, or extradural. In this study, We have investigated to illuminate the role of hemilaminectomy in benign spinal cord tumors, which occupy the spinal canal. Materials and Methods: 15 patients with spinal tumors who were operated on with hemilaminectomy were included in the evaluation. The hemilaminectomy method was chosen based on the size, laterality, number of segments involved, and possible pathologies. The demographics of the subjects, as well as their operating reports, histological results, pre- and postoperative images, and follow-up information, were examined. Frankel grade classification was used to assess the neurological status on admission and during follow-up. Results: The mean age of the patients was 48.4 years. Nine of the patients were male and 6 were female. According to tumor localization, 3 of them were cervical, 7 were thoracic, and 5 were lumbar. 4 of them were meningiomas, 6 were ependymomas, and 5 were schwannomas. One patient was worse than the pre-operative, and the post-operative grades of the remaining 11 patients were similar to the pre-operative grades. Post-operative imaging showed that gross-total resection was achieved in all patients. Conclusion: If used correctly and with a reasonable learning curve, limited unilateral hemilaminectomy can offer enough access to the dural sac, allowing for safe resection of nearly all spinal intradural and extradural lesions. Because it takes less time to operate than a standard laminectomy, it is better for older or high-risk patients.
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