组合式微创手术治疗胸椎侵袭性血管瘤
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新疆医科大学附属中医医院

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新疆维吾尔自治区自然科学基金-青年科学基金


Combined minimally invasive surgery for invasive hemangioma of thoracic vertebrae
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Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University

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Natural Science Foundation of Xinjiang Uygur Autonomous Region - Youth Science Foundation

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    摘要:

    【摘要】 目的:探讨组合式微创手术治疗胸椎侵袭性血管瘤的临床疗效。方法:选取2023年1月至2023年12月在新疆医科大学附属中医医院脊柱二科住院确诊为胸椎侵袭性血管瘤并自愿行手术治疗的患者1例。采用“经皮椎体成形术+椎间孔镜下椎管占位病变摘除术”手术技术对该患者进行治疗,记录患者术前1天、术后1周及术后超过3个月的结局观察指标,包括VAS疼痛评分、Lovett分级和影像学表现。利用自身前后对照的方式对上述观察指标进行对比,明确组合式微创手术治疗胸椎侵袭性血管瘤的临床疗效。结果:术后1周复查胸椎MRI平扫+增强提示椎管内血管瘤约60%被摘除,术区渗出明显;术后4月随访与术后1周复查结果对比,显示椎管内未完全摘除的血管瘤逐渐皱缩,未见明显复发增大改变,受压脊髓明显恢复,且术区渗出完全吸收,腰背部疼痛VAS评分:0/10,右下肢肌力恢复至4级+。结论:组合式微创手术方式为胸椎侵袭性血管瘤的微创治疗方法提供了新思路,且治疗效果良好。

    Abstract:

    [Abstract] Objective: To investigate the clinical efficacy of combined minimally invasive surgery in the treatment of invasive hemangioma of thoracic vertebrae. Methods: From January 2023 to December 2023, a patient diagnosed with invasive hemangioma of the thoracic vertebra was admitted to the Second Department of Spine of the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University and voluntarily underwent surgical treatment. The patient was treated with the surgical technique of "percutaneous vertebroplasty + extractor of vertebral canal space occupying lesion under foraminoscope", and the outcome indicators of the patient were recorded 1 day before surgery, 1 week after surgery and more than 3 months after surgery, including VAS pain score, Lovett scale and imaging findings. The clinical efficacy of combined minimally invasive surgery for invasive hemangioma of thoracic vertebrae was determined by comparing the above observation indexes with self-before-after comparison. Results: One week after surgery, thoracic MRI scan + enhancement showed that about 60% of intraspinal hemangioma was removed, and the intraoperative area exudated obviously. The results of 4-month postoperative follow-up and 1-week postoperative review showed that the hemangioma that was not completely removed in the spinal canal gradually shrank, no significant recurrence or increase was observed, the spinal cord recovered significantly under compression, and the operative area exudated and fully absorbed, the VAS score of low back pain was 0/10, and the muscle strength of the right lower limb recovered to grade 4 +. Conclusion: Combined minimally invasive surgery provides a new idea for the minimally invasive treatment of invasive hemangioma of thoracic vertebrae, and the therapeutic effect is good.

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  • 收稿日期:2023-10-17
  • 最后修改日期:2023-12-26
  • 录用日期:2024-04-02
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