■脊髓神经鞘瘤是最常见的髓外硬膜内肿瘤,建议将其完全切除以避免肿瘤复发。尽管椎板成形术为肿瘤切除提供了足够的窗口,与单侧半椎板切除术相比,这种方法可能增加组织创伤并导致术后不稳定.本研究旨在比较两种方法的疗效和临床结果。
■我们纳入了在2015年1月至2023年2月期间接受单侧半椎板切除术或椎板成形术切除脊髓神经鞘瘤的100例连续患者。患者的基线特征,包括性,年龄,肿瘤位置,肿瘤占硬膜内间隙的百分比,手术时间,术后住院时间,术中出血量,视觉模拟量表评分,和神经结果,进行回顾性分析。
■接受单侧半椎板切除术的患者术中出血量较小(p=0.020),手术时间短(p=0.012),术后住院时间较短(p=0.044)。末次随访时两组的平均VAS评分相似(p=0.658)。尽管椎板成形术组和单侧半椎板切除术组的术后McCormick和Karnofsky性能评分没有显着差异(分别为p=0.687和p=0.649),两组的术后神经学结果相比于术前神经学结果均有统计学意义的改善.单侧半椎板切除及椎板成形术组术后并发症发生率分别为5%和11.7%,分别(p=0.308)。
■对于脊柱神经鞘瘤切除术,单侧半椎板切除术比椎板成形术更有优势,包括术后住院时间缩短,更快的程序,减少术中失血,同时达到相同的预期结果。
UNASSIGNED: Spinal schwannomas are the most common intradural extramedullary tumors, and their complete removal is recommended to avoid tumor recurrence. Although laminoplasty provides a sufficient window for tumor resection, this approach may increase tissue trauma and cause postoperative instability compared with unilateral hemilaminectomy. This study aimed to compare the efficacy and clinical outcomes of the two approaches.
UNASSIGNED: We included 100 consecutive patients who underwent unilateral hemilaminectomy or laminoplasty for resection of spinal schwannomas between January 2015 and February 2023. The patients\' baseline characteristics, including sex, age, tumor location, percentage of tumor occupying the intradural space, operative time, postoperative length of hospital stay, intraoperative bleeding volume, visual analog scale score, and neurologic results, were retrospectively analyzed.
UNASSIGNED: Hemilaminectomy patients who underwent unilateral hemilaminectomy had smaller intraoperative bleeding (p = 0.020) volume, shorter operative time (p = 0.012), and shorter postoperative length of hospital stay (p = 0.044). The mean VAS scores at the last follow-up were similar between the two groups (p = 0.658). Although the postoperative McCormick and Karnofsky Performance scores were not significantly different between the laminoplasty and unilateral hemilaminectomy groups (p = 0.687 and p = 0.649, respectively), there was a statistically significant improvement based on postoperative neurological results compared to preoperative neurological results for both groups. The incidence of postoperative complications was 5% and 11.7% in the unilateral hemilaminectomy and laminoplasty groups, respectively (p = 0.308).
UNASSIGNED: For spinal schwannoma resection, unilateral hemilaminectomy has more advantages than laminoplasty, including a shorter postoperative hospital stay, faster procedure, and less intraoperative blood loss while achieving the same desired result.