PDF(Pubmed)
Abstract：
BACKGROUND: Minimally invasive treatments for spinal cord tumours are common. The aim of this study was to compare the perioperative outcomes of patients with thoracic extramedullary spinal tumours (TEST) treated by microendoscopic minimally invasive surgery-hemilaminectomy through a homemade tubular retractor (MIS-TR) and microscopic full laminectomy (open surgery).
METHODS: Between February 2016 and February 2021, 51 patients with TEST were included. According to their clinical data, patients were classified into the MIS-TR group (n = 30) and the open surgery group (n = 21) and assessed.
RESULTS: In both groups, the mean operation time, change in perioperative ASIA score, and modified Macnab score were comparable. The average postoperative hospital stay in the MIS-TR group was substantially shorter than that in the open surgery group (p < 0.0001). The mean blood loss volume in the MIS-TR group was substantially lower than that in the open surgery group (p = 0.001). The perioperative complication rate in the MIS-TR group was considerably lower than that in the open surgery group (p < 0.0001). At the 3-month follow-up, there was no substantial difference in the Oswestry Disability Index (ODI) score improvement between the two groups. Nonetheless, at the 12-month follow-up, the average ODI in the MIS-TR group was considerably lower than that in the open surgery group (p = 0.023). The main influencing factors for complete postoperative recovery were preoperative ASIA score (OR 7.848, P = 0.002), surgical complications (OR 0.017, P = 0.008) and age (OR 0.974, P = 0.393).
CONCLUSIONS: MIS-TR is safer and more effective than open surgery for treating TEST, but the long-term recovery of MIS-TR is not better than that of open surgery.
METHODS: Between February 2016 and February 2021, 51 patients with TEST were included. According to their clinical data, patients were classified into the MIS-TR group (n = 30) and the open surgery group (n = 21) and assessed.
RESULTS: In both groups, the mean operation time, change in perioperative ASIA score, and modified Macnab score were comparable. The average postoperative hospital stay in the MIS-TR group was substantially shorter than that in the open surgery group (p < 0.0001). The mean blood loss volume in the MIS-TR group was substantially lower than that in the open surgery group (p = 0.001). The perioperative complication rate in the MIS-TR group was considerably lower than that in the open surgery group (p < 0.0001). At the 3-month follow-up, there was no substantial difference in the Oswestry Disability Index (ODI) score improvement between the two groups. Nonetheless, at the 12-month follow-up, the average ODI in the MIS-TR group was considerably lower than that in the open surgery group (p = 0.023). The main influencing factors for complete postoperative recovery were preoperative ASIA score (OR 7.848, P = 0.002), surgical complications (OR 0.017, P = 0.008) and age (OR 0.974, P = 0.393).
CONCLUSIONS: MIS-TR is safer and more effective than open surgery for treating TEST, but the long-term recovery of MIS-TR is not better than that of open surgery.
摘要：
背景：脊髓肿瘤的微创治疗很常见。这项研究的目的是比较经微内镜微创手术-通过自制管状牵开器（MIS-TR）和显微全椎板切除术（开放手术）治疗的胸髓外脊柱肿瘤（TEST）患者的围手术期结果。
方法：2016年2月至2021年2月，纳入了51例TEST患者。根据他们的临床数据,将患者分为MIS-TR组(n=30)和开放手术组(n=21)并进行评估.
结果：在两组中，平均手术时间，围手术期ASIA评分的变化，和改良的Macnab评分具有可比性。MIS-TR组术后平均住院时间明显短于开放手术组(p<0.0001)。MIS-TR组的平均失血量明显低于开放手术组（p=0.001）。MIS-TR组围手术期并发症发生率明显低于开放手术组(p<0.0001)。在3个月的随访中，两组间Oswestry残疾指数(ODI)评分改善无显著差异.尽管如此，在12个月的随访中，MIS-TR组的平均ODI显著低于开放手术组(p=0.023).术后完全恢复的主要影响因素为术前ASIA评分(OR7.848,P=0.002),手术并发症(OR0.017,P=0.008)和年龄(OR0.974,P=0.393)。
结论：MIS-TR比开放手术治疗TEST更安全有效，但MIS-TR的长期恢复并不比开放手术好。
方法：2016年2月至2021年2月，纳入了51例TEST患者。根据他们的临床数据,将患者分为MIS-TR组(n=30)和开放手术组(n=21)并进行评估.
结果：在两组中，平均手术时间，围手术期ASIA评分的变化，和改良的Macnab评分具有可比性。MIS-TR组术后平均住院时间明显短于开放手术组(p<0.0001)。MIS-TR组的平均失血量明显低于开放手术组（p=0.001）。MIS-TR组围手术期并发症发生率明显低于开放手术组(p<0.0001)。在3个月的随访中，两组间Oswestry残疾指数(ODI)评分改善无显著差异.尽管如此，在12个月的随访中，MIS-TR组的平均ODI显著低于开放手术组(p=0.023).术后完全恢复的主要影响因素为术前ASIA评分(OR7.848,P=0.002),手术并发症(OR0.017,P=0.008)和年龄(OR0.974,P=0.393)。
结论：MIS-TR比开放手术治疗TEST更安全有效，但MIS-TR的长期恢复并不比开放手术好。
