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目的:探讨单侧半椎板显微手术在治疗椎管内硬膜下肿瘤中的应用。方法:回顾性分析浙江大学医学院附属第二医院神经外科于2009年9月至2012年4月采用单侧半椎板显微手术治疗的30例椎管内硬膜下肿瘤的临床资料。结果:经单侧半椎板开窗显微手术切除的30例椎管内髓外膜内肿瘤,29例全切除,1例脂肪瘤患者因肿瘤与神经根关系密切行部分切除。手术时间短,术中出血少,术后无切口感染及脑脊液漏发生。卧床时间短,恢复快。随访时间3个月至22个月,平均14个月,没有发现肿瘤复发或椎体滑移。结论:经单侧半椎板结合显微神经外科技术,手术创伤小,对脊柱结构破坏少,避免术中过度显暴露,术后脊柱的三柱结构可以最大程度的保留,有利于保持脊柱的稳定性(尤其是颈段和腰段),术后患者恢复快,适用于绝大部分椎管内硬膜下肿瘤。
Objective: To investigate the application of unilateral hemilaminectomy in the treatment of subdural tumors of the spinal canal. Methods: The clinical data of 30 cases of subdural tumors of the spinal canal treated with unilateral hemilaminectomy in Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University Medical College from September 2009 to April 2012 were retrospectively analyzed. Results: Thirty patients with intramedullary adventitial tumors who underwent microsurgical resection with unilateral hemilaminectomy were resected in 29 patients with complete resection and 1 patient with lipoma due to the close relationship between tumor and nerve root. Short operative time, less intraoperative bleeding, no incision infection and cerebrospinal fluid leakage. Bed time is short, fast recovery. The follow-up time ranged from 3 months to 22 months with an average of 14 months. No tumor recurrence or vertebral slippage was found. Conclusion: The unilateral hemi-laminectomy combined with micro-neurosurgery has the advantages of less operation trauma, less damage to the spine structure and avoidance of excessive intraoperative exposure. The three-column structure of the spine can be preserved to the maximum extent, which is good for maintaining the spine Stability (especially cervical and lumbar), postoperative patients recover quickly, suitable for most subdural tumors of the spinal canal.