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目的探讨微创小椎板切除技术在脊髓神经鞘瘤手术中应用的意义。方法回顾性分析45例接受微创小椎板切除法治疗脊髓神经鞘瘤患者的临床资料。结果肿瘤位于硬膜下髓外32例,硬膜下硬膜外哑铃状肿瘤6例,硬膜外鞘袖型5例,髓内肿瘤2例。肿瘤最大径2~9 cn。手术应用微创小椎板切除法在显微镜下行肿瘤切除,45例均达全切除。住院期间32例症状好转,13例稳定。出院后随访时间5~40个月,获随访43例,好转38例,稳定5例;无手术区肿瘤复发、病情加重,无脊柱稳定性相关并发症,未见脊柱变形。结论微创小椎板切除入路手术切除脊髓神经鞘瘤安全、创伤小,术后不需脊柱稳定性加固,较常规手术操作难度无明显增大;但在较大体积的髓内型脊髓神经鞘瘤慎用。
Objective To investigate the significance of minimally invasive small laminectomy in spinal schwannoma surgery. Methods The clinical data of 45 patients with spinal schwannoma treated by minimally invasive minimally invasive laminectomy were retrospectively analyzed. Results The tumors were located in 32 cases of extramedullary extramedullary extradural dumbbell tumors, 6 cases of epidural sheath in 5 cases and 2 cases of intramedullary tumors. The largest tumor diameter 2 ~ 9 cn. Surgical operation of minimally invasive small laminectomy tumor resection under the microscope, 45 patients were up to total resection. 32 cases during hospitalization improved symptoms, 13 cases were stable. The patients were followed up for 5 to 40 months after discharge. Among them, 43 cases were followed up, 38 cases improved, and 5 cases were stable. No tumor recurrence was found in the operation area. There was no complication of spine stability and no spine deformation. Conclusions Minimally invasive small laminectomy is safe and traumatic for the removal of neurilengioma in the spinal cord, and does not require stabilization of the spine after operation. Compared with the conventional operation, the difficulty of operation is not obviously increased. However, in the case of larger volume of intramedullary spinal cord nerve Sphincter caution.