CAJ | 학술논문

目的探讨胸腰椎哑铃型椎管肿瘤的手术入路及手术方法. 方法回顾性分析自2005年1月至2011年5月厦门大学附属福州第二医院收治的16例胸腰椎哑铃型椎管肿瘤(神经鞘瘤14例,神经纤维瘤2例)患者的手术方式及疗效,应用脊髓功能评分(JOA评分)及疼痛评分(VAS评分)评价术前术后神经功能改善情况. 结果将肿瘤分为Ⅰ、Ⅱ、Ⅲ型,其中Ⅰ型11例,选择后正中入路手术;Ⅱ型2例,选择经椎旁肌间隙入路手术;Ⅲ型3例,选择侧方入路手术.16例患者的肿瘤均彻底切除.术后随访患者神经功能明显改善;JOA评分术前为17.69±1.05,术后为25.38±0.42,比较差异有统计学意义(P＜0.05);VAS评分术前为6.13±0.26,术后为1.75±0.25,比较差异有统计学意义(P＜0.05). 结论对胸腰椎哑铃型椎管肿瘤进行分型有助于手术方式的选择,并有利于手术疗效的提高.
목적 탐토흉요추아령형추관종류적수술입로급수술방법. 방법 회고성분석자2005년1월지2011년5월하문대학부속복주제이의원수치적16례흉요추아령형추관종류(신경초류14례,신경섬유류2례)환자적수술방식급료효,응용척수공능평분(JOA평분)급동통평분(VAS평분)평개술전술후신경공능개선정황. 결과 장종류분위Ⅰ、Ⅱ、Ⅲ형,기중Ⅰ형11례,선택후정중입로수술;Ⅱ형2례,선택경추방기간극입로수술;Ⅲ형3례,선택측방입로수술.16례환자적종류균철저절제.술후수방환자신경공능명현개선;JOA평분술전위17.69±1.05,술후위25.38±0.42,비교차이유통계학의의(P＜0.05);VAS평분술전위6.13±0.26,술후위1.75±0.25,비교차이유통계학의의(P＜0.05). 결론 대흉요추아령형추관종류진행분형유조우수술방식적선택,병유리우수술료효적제고.
Objective To study the surgical approach and surgical method of thoracolumbar dumbbell spinal tumors.Methods A retrospective analysis of operation method and curative effect of 16 patients with thoracolumbar dumbbell spinal tumors,admitted to our hospital from January 2005 to May 2005,including 14 with schwanmomas and two with nerve fibromas,was performed.Japanese orthopaedic association (JOA) scale and visual analogue scale (VAS) were used to evaluate the improvement of neurological function.Results According to Asazuma's method of classifing the spinal canal tumors,the tumors could be divided into type Ⅰ,Ⅱ and Ⅲ; a total of 11 patients were included in type Ⅰ and operation through posterior median approach was chosen; two patients were included in type Ⅱ and operation through Wiltse paraspinal sacrospinalis splitting approach was chosen; three patients were included in type Ⅲ and operation through posterior approach was chosen.Sixteen patients achieved total resection.Postoperative follow-up indicated obvious nerve function improvment:JOA scale scores before surgery (17.69±1.05) were significantly lower than those after surgery (25.38±0.42,P＜0.05); VAS scores before surgery were 6.13 ±0.26 and those after surgery were 1.75±0.25,with statistically significant differences (P＜0.05).Conclusion Partition of the thoracolumbar dumbbell spinal tumors is helpful to the choice of operation methods.