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- 2016
经Quadrant通道椎管内肿瘤切除与传统半椎板椎管内肿瘤切除术的对比研究
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Abstract:
摘要:目的 对比分析经Quadrant通道显微镜下椎管内肿瘤切除与传统显微手术椎管内肿瘤切除的手术相关指标和疗效。方法 回顾自2013年7月至2015年7月本院33例病变长度小于5cm的椎管内肿瘤患者,其中16例接受经Quadrant通道显微镜下椎管内肿瘤切除,另外17例接受传统半椎板椎管内肿瘤切除。比较两组患者相关指标,包括手术切口长度、手术时间、术中出血量、术后首次下地活动时间、术后住院时间、术后1周视觉疼痛模拟(VAS)评分、JOA评分治疗改善率等。结果 与传统手术相比,Quadrant通道手术组患者在手术切口长度、术中出血量、术后首次下地活动时间、术后住院时间、术后1周视觉疼痛模拟(VAS)评分等方面均优于传统组(P<0.05)。结论 经Quadrant通道显微镜下椎管内肿瘤切除术具有创伤小、出血少、恢复快、疗效肯定的优点,是一种安全有效的治疗椎管内较小肿瘤的方法。
ABSTRACT: Objective To compare the clinical efficacy of intraspinal tumor resection under quadrant channel and hemilaminectomy surgery. Methods We retrospectively studied 33 patients with intraspinal tumor with the lesion length of less than 5cm hospitalized in our hospital from July 2013 to July 2015. Of the 33 patients, 16 patients received intraspinal tumor resection under quadrant channel and 17 patients received intraspinal tumor resection under hemilaminectomy surgery. We compared various indicators in the two groups, including the length of surgical incision, surgical operation time, bleeding volume during operation, time for the first ground activity after surgery, length of hospital stay (LOS) after surgery, visual pain simulation (VAS) score 1 week after surgery, and JOA score excellent and good rates. Results The patients who received quadrant channel intraspinal tumor resection outperformed those who received hemilaminectomy surgery regarding the length of surgical incision, bleeding volume during operation, time for the first ground activity after surgery, LOS after surgery, and VAS score 1 week after surgery (P<0.05). Conclusion Intraspinal tumor resection under quadrant channel is a safe and effective therapy because of small trauma, less bleeding, quick recovery and curative effect
[1] | UEHARA M, TAKAHASHI J, KURAISHI S, et al. |
[2] | 王忠诚. 神经外科学[M]. 武汉:湖北科学技术出版社, 2004:967-972. |
[3] | ARORA N, GRENIER SG. Acute effects of whole body vibration on directionality and reaction time latency of trunk muscles: the importance of rest and implications for spine stability[J]. J Electromyogr Kinesiol, 2013, 23(2):394-401. |
[4] | Mini open foraminotomy for cervical radiculopathy: A comparison of large tubular and trimline retractors[J]. Asian Spine J, 2015, 9(4):548-552. |
[5] | 陈春美,蔡刚峰,王锐,等. 经皮套管椎旁入路显微切除腰椎椎管内肿瘤[J].中华医学杂志, 2015, 95(13). |
[6] | GU R, LIU JB, XIA P, et al. Evaluation of hemilaminectomy use in microsurgical resection of intradural extramedullary tumors[J]. Oncology letters, 2014, 7(5):1669. |
[7] | 赵龙,唐晓平,彭华,等. 经半椎板显微手术切除多节段神经鞘瘤1例并文献复习[J]. 川北医学院学报, 2012, 27(6). |
[8] | SIMON SL, AUERBACH JD, GARG S, et al. Efficacy of spinal instrumentation and fusion in the prevention of postlaminectomy spinal deformity in children with intramedullary spinal cord tumors[J]. J Pediatr Orthop, 2008,28:244-249. |
[9] | ZONG S, ZENG G, DU L, et al. Treatment results in the different surgery of intradural extramedullary tumor of 122 cases[J]. PloS One, 2014, 9(11):elll495. |
[10] | GHAHREMAN A, FERCH RD, RAO PJ, et al. Minimal access versus open posterior lumbar interbody fusion in the treatment of spondylolisthesis[J]. Neurosurgery, 2010, 66(2):296-304. |
[11] | 黄思庆,王跃龙. 椎管内肿瘤手术脊柱稳定性的保护与重建[J]. 中国现代神经疾病杂志, 2013, 13(11):920-923. |
[12] | MESFIN A, BUCHOWSKI JM, GOKASLAN ZL, et al. Management of metastatic cervical spine tumors[J]. Am Acad Orthop Surg, 2015, 23(1):38-46. |
[13] | OZGUR BM, YOO K, RODRIGUEZ G, et al. Minimally-invasive technique for transforaminal lumbar interbody fusion (TLIF)[J]. Eur Spine J, 2005, 14(9):887-894. |
[14] | IACOANGELI M, GLADI M, DI RIENZO A, et al. Minimally invasive surgery for benign intradural extramedullary spinal meningiomas: experience of a single institution in a cohort of elderly patients and review of the literature[J]. Clin Inter Aging, 2011,7:557-564. |
[15] | YU Y, ZHANG X, HU F, et al. Minimally invasive microsurgical treatment of cervical intraspinal extramedullary tumors[J]. J Clin Neuroscience, 2011,18(9):1168-1173. |