显微镜手术切除腰椎椎管内硬膜下肿瘤△

Microscopic resection of lumbar intradural spinal tumors

摘要:

［目的］评价显微镜手术切除腰椎椎管内硬膜下肿瘤的临床疗效。［方法］回顾性分析 2016 年 4 月—2019 年 4 月显微镜下手术切除腰椎椎管内硬膜下肿瘤 32 例患者的临床资料。评价临床与影像资料。［结果］所有患者均顺利完成手术，术中无严重并发症，手术时间（135.35±28.57）min，术中出血量（108.2±12.95）ml，术后住院时间（9.01±2.05）d。随访时间（9.03±2.01）个月，末次随访时肌力基本恢复正常，未见肿瘤复发及脊柱畸形。随时间推移，VAS、JOA 评分及 Frankel 显著改善（P<0.05）。影像学结果显示 32 例患者均完整切除肿瘤，随访期间未见肿瘤复发及脊柱畸形，脊柱稳定性良好，局部脊柱无明显退行性改变。［结论］显微镜下手术切除腰椎椎管内硬膜下肿瘤具有创伤小、恢复快的特点，可有效恢复脊髓功能。

Abstract:

[Objective] To evaluate the clinical efficacy of microscopic resection of lumbar intradural spinal tumors. [Methods] A retro- spective study was conducted on 32 patients who received microscopic resection of lumbar intradural spinal tumors in our department from April 2016 to April 2019. The clinical and imaging data were evaluated. [Results] All the patients were successfully operated without seri- ous complications, while with operative time of (135.35±28.57) min, the intraoperative bleeding of (108.2±12.95) ml, and the postoperative hospital stay of (9.01±2.05) days. At the latest follow-up lasted for (9.03±2.01) months, all of them regained muscle strength to basically normal level, without tumor recurrence or spinal deformity. The VAS and JOA scores, as well as Frankel index for neurological function im- proved significantly over time (P＜0.05) . Radiographic checks showed that the tumors were resected completely in all the patients, and no tumor recurrence or spinal deformity was observed during the follow-up period, with good spinal stability and no significant degenerative changes of the involved spinal segment. [Conclusion] Microscopic resection of lumbar intradural tumors has the advantages of minimizing iatrogenic trauma and improving recovery, and does effectively restore spinal cord function.