CAJ | 학술논문

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 cm。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。
목적：탐토미창소추판절제기술재척수신경초류수술중응용적의의。방법회고성분석45례접수미창소추판절제법치료척수신경초류환자적림상자료。결과종류위우경막하수외32례，경막하경막외아령상종류6례，경막외초수형5례，수내종류2례。종류최대경2~9 cm。수술응용미창소추판절제법재현미경하행종류절제，45례균체전절제。주원기간32례증상호전，13례은정。출원후수방시간5~40개월，획수방43례，호전38례，은정5례；무수술구종류복발、병정가중，무척주은정성상관병발증，미견척주변형。결론미창소추판절제입로수술절제척수신경초류안전、창상소，술후불수척주은정성가고，교상규수술조작난도무명현증대；단재교대체적적수내형척수신경초류신용。
Aim To explore the significance of minimally invasive small laminectomy technology for application in spinal schwannoma operation. Methods A retrospective analysis was undertaken for the clinical data of 45 cases of schwannoma of spinal cord with the minimally invasive operation. Results Tumors of 32 cases were located in the subdural, subdural and epidural dumbbell shaped tumors in 6 cases, epidural tumors in 5 cases, intramedullary spinal cord tumors in 2 cases. The largest tumor length was 2-9 cm. The minimally invasive small laminectomy technology were used in operations of tumor resection with microscope, the tumor total excisions were in all 45 cases. The symptoms improved in 32 cases during hospitalization, 13 cases were stable. 43 cases were followed up for 5 to 40 months. 38 cases improved, 5 cases were stable. There were no tumor recurrence in operation region, no exacerbation, no spinal stability related complications, no distortion of the spine. Conclusion The operations of resection of spinal cord schwannomas with minimally invasive small laminectomy approach are a safe small trauma without spinal stability reinforcement post operation, no more difficult than conventional laminectomy technology. But it should be treated with caution in the large schwannoma of spinal cord intramedullary.