Zong Shaohui, Zeng Gaofeng, Du Li, Fang Ye, Gao Taihang, Zhao Jingmin
Department of Spine Osteopathia, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China.
College of Public Hygiene of Guangxi Medical University, Nanning, Guangxi, P.R. China.
PLoS One. 2014 Nov 5;9(11):e111495. doi: 10.1371/journal.pone.0111495. eCollection 2014.
A retrospective study of intradural extramedullary tumor.
To compare the treatment results in the different surgeries of spinal intradural extramedullary tumor.
The study retrospectively reviewed 122 patients. The minimally invasive surgery (MIS) group was divided into Group A (hemilaminectomy + tumor microscopic excision) and Group B (laminectomy + tumor microscopic excision + pedicle screw fixation). Meanwhile, the non-MIS group was divided into Group C (hemilaminectomy + tumor excision), Group D (laminectomy + tumor excision), and Group E (laminectomy + tumor excision + pedicle screw fixation). In order to study postoperative spinal stability, we simultaneously divided all of the subjects into three categories, namely Group HE: hemilaminectomy + tumor excision; Group LE: laminectomy + tumor excision; and Group LEPSF: laminectomy + tumor excision + pedicle screw fixation.
The MIS group exhibited fewer postoperative complications (p<0.05), better short-term clinical efficacy (p<0.05) and less non-surgical cost (p<0.05) than in non-MIS group. The rate of postoperative spinal instability in hemilaminectomy was lower than in laminectomy in a single spinal segment (p<0.05). The rate of postoperative spinal instability in laminectomy + pedicle screw fixation was lower than in hemilaminectomy and laminectomy in two or more spinal segments (p<0.05).
In the case of appropriate surgical indications, minimally invasive surgery for intradural extramedullary tumor is a useful method that can successfully produce good clinical results and reduce non-surgical cost. In addition, pedicle screw fixation helps avoid spinal postoperative instability.
硬脊膜内髓外肿瘤的回顾性研究。
比较脊柱硬脊膜内髓外肿瘤不同手术方式的治疗效果。
本研究回顾性分析了122例患者。微创手术(MIS)组分为A组(半椎板切除术+肿瘤显微切除术)和B组(全椎板切除术+肿瘤显微切除术+椎弓根螺钉内固定)。同时,非微创手术组分为C组(半椎板切除术+肿瘤切除术)、D组(全椎板切除术+肿瘤切除术)和E组(全椎板切除术+肿瘤切除术+椎弓根螺钉内固定)。为研究术后脊柱稳定性,我们同时将所有受试者分为三类,即HE组:半椎板切除术+肿瘤切除术;LE组:全椎板切除术+肿瘤切除术;LEPSF组:全椎板切除术+肿瘤切除术+椎弓根螺钉内固定。
与非微创手术组相比,微创手术组术后并发症更少(p<0.05),短期临床疗效更好(p<0.05),非手术费用更低(p<0.05)。单节段半椎板切除术的术后脊柱不稳发生率低于全椎板切除术(p<0.05)。在两个或更多节段,全椎板切除术+椎弓根螺钉内固定的术后脊柱不稳发生率低于半椎板切除术和全椎板切除术(p<0.05)。
在有合适手术指征的情况下,硬脊膜内髓外肿瘤的微创手术是一种有效的方法,能成功取得良好的临床效果并降低非手术费用。此外,椎弓根螺钉内固定有助于避免脊柱术后不稳。