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目的探讨椎管内神经鞘瘤应用后入路椎板切除术治疗的临床疗效。方法回顾性分析2010年1月至2011年12月间收治的65例椎管内神经鞘瘤行后入路椎板切除术患者的临床资料。结果患者均顺利完成手术,平均手术时间为(2.7±1.0)h,平均出血量为(482.8±114.4)ml。术后5例患者发生脑脊液漏,2例患者麻醉清醒后出现运动功能障碍。术后经1~2年的随访,无一例患者肿瘤复发。治疗后肌力均恢复到4级或5级,差异有统计学意义(P<0.05)。依据日本骨科协会评估治疗评分标准(JOA),治疗后患者JOA评分明显高于治疗前,差异有统计学意义(P<0.05)。结论椎管内神经鞘瘤后入路椎板切除术可充分暴露肿瘤,缩短手术时间,提高临床疗效和肌力,值得临床应用与推广。
Objective To investigate the clinical efficacy of posterior laminectomy for the treatment of schwannoma in the spinal canal. Methods The clinical data of 65 patients with neurilemmoma of the spinal canal who underwent posterior laminectomy between January 2010 and December 2011 were analyzed retrospectively. Results All patients underwent successful operation. The average operation time was (2.7 ± 1.0) h, and the average bleeding volume was (482.8 ± 114.4) ml. Cerebrospinal fluid leakage occurred in 5 patients after surgery, and motor dysfunction occurred in 2 patients after anesthesia was awake. After 1 to 2 years of follow-up, none of the patients had tumor recurrence. After treatment, the muscle strength recovered to grade 4 or 5, the difference was statistically significant (P <0.05). According to the Japanese Association of Orthopedic Association assessment of treatment score (JOA), postoperative JOA score was significantly higher than before treatment, the difference was statistically significant (P <0.05). Conclusion Posterior spinal schwannoma laminectomy can fully expose the tumor, shorten the operation time and improve clinical efficacy and strength, which is worthy of clinical application and promotion.