Kato Yoshihiko, Kaneko Kazuo, Kataoka Hideo, Kojima Takanori, Imajyo Yasuaki, Taguchi Toshihiko
Department of Orthopedic Surgery, Yamaguchi University School of Medicine, 1-1-1, Minami-Kogushi, Ube, Yamaguchi, Japan.
J Spinal Disord Tech. 2007 Jun;20(4):296-301. doi: 10.1097/01.bsd.0000211287.98895.a3.
Ten patients with cervical spinal schwannomas were operated using a new posterior approach, termed cervical hemilaminoplasty. A thread wire saw (T-saw) was used to cut the lamina at the center of the spinous process and at the unilateral pars interarticularis on the affected side. The unilateral lamina, the inferior articular process, and half of the spinous process were resected as a single mass. After tumor excision, the resected lamina was restored to the original site and fixed. Fusion technique was not required. The mean number of resected and restored lamina was 1.5. No instability of the cervical spine was detected using flexion/extension x-ray photography. Although worsening of radicular motor function was observed in 2 cases, the weakness was not permanent and both cases showed full recovery. Postoperative magnetic resonance imaging was performed in 7 of the 10 cases and showed no recurrences. Cervical hemilaminoplasty is a useful posterior approach method for spinal tumors and especially dumbbell-type tumors. This method provides wide exposure of the foramen and of the inside of the canal. Furthermore, it allows reconstruction of the posterior element of the spinal canal and results in good stability.
10例颈椎神经鞘瘤患者采用一种新的后路手术方法，即颈椎半椎板成形术进行手术。使用线锯（T锯）在棘突中心和患侧单侧关节突处切断椎板。将单侧椎板、下关节突和一半棘突作为一个整体切除。肿瘤切除后，将切除的椎板恢复到原位并固定。无需融合技术。切除并恢复的椎板平均数量为1.5个。通过屈伸位X线摄影未检测到颈椎不稳。虽然2例患者出现神经根运动功能恶化，但无力并非永久性的，且2例均完全恢复。10例患者中有7例进行了术后磁共振成像，结果显示无复发。颈椎半椎板成形术是一种用于脊柱肿瘤尤其是哑铃型肿瘤的有用的后路手术方法。该方法可广泛暴露椎间孔和椎管内部。此外，它允许重建椎管的后部结构并具有良好的稳定性。
