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全椎板切除术与超声和显微镜辅助椎板再植后路内固定治疗腰椎管内肿瘤的比较:单中心 60 例回顾性研究。

Comparison of Total Laminectomy and Pedicle Screw Internal Fixation with Ultrasonic- and Microscopic-Assisted Laminectomy Replantation for Tumors of the Lumbar Spinal Canal: A Retrospective Study of 60 Cases from a Single Center.

机构信息

The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, Jiangsu, China (mainland).

China-Japan Union Hospital of Jilin University, Changchun, Jilin, China (mainland).

出版信息

Med Sci Monit. 2021 Sep 22;27:e931768. doi: 10.12659/MSM.931768.

DOI:10.12659/MSM.931768
PMID:34548468
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8475735/
Abstract

BACKGROUND Total laminectomy with pedicle screw internal fixation is the most common surgical procedure for patients with primary tumors arising in the spinal canal, but the procedure has several limitations. This study aimed to compare total laminectomy and pedicle screw internal fixation with ultrasound- and microscope-assisted laminectomy replantation surgery in patients with tumors of the lumbar spinal canal. MATERIAL AND METHODS A retrospective study was conducted. Sixty patients with tumor spinal canal were admitted to our hospital. Patients in group A (n=32) underwent total laminectomy and pedicle screw internal fixation; patients in group B (n=28) underwent laminectomy replantation with ultrasonic and microscopic assistance. Operative time, intraoperative blood loss, operative segment, length of hospital stay, postoperative length of bed rest, and visual analog scale (VAS) score after surgery were analyzed. RESULTS Hospital stay and postoperative bed rest time of patients in group B were shorter than those in group A (P=0.004). Intraoperative blood loss, postoperative drainage volume, and postoperative pain relief of group B were significantly lower than those of group A (P=0.000). There was no significant difference in postoperative pathological results between the 2 groups (P=0.901). CONCLUSIONS Ultrasound- and microscope-assisted laminectomy replantation resulted in the reduced intraoperative blood loss, postoperative drainage volume, length of hospital stay, and postoperative VAS pain score, compared with total laminectomy and pedicle screw internal fixation for the surgical removal of tumors of the lumbar spinal canal.

摘要

背景

全椎板切除加钉棒内固定术是椎管内原发性肿瘤患者最常用的手术方法,但该方法存在一些局限性。本研究旨在比较超声和显微镜辅助下椎板切除再植术与全椎板切除加钉棒内固定术治疗腰椎管内肿瘤的疗效。

材料与方法

回顾性研究。我院收治 60 例椎管内肿瘤患者。A 组(n=32)患者行全椎板切除加钉棒内固定术;B 组(n=28)患者行超声和显微镜辅助下椎板切除再植术。分析手术时间、术中出血量、手术节段、住院时间、术后卧床时间和术后视觉模拟评分(VAS)。

结果

B 组患者的住院时间和术后卧床时间均短于 A 组(P=0.004)。B 组患者的术中出血量、术后引流量和术后疼痛缓解程度均明显低于 A 组(P=0.000)。两组患者术后病理结果无显著差异(P=0.901)。

结论

与全椎板切除加钉棒内固定术相比,超声和显微镜辅助下椎板切除再植术可减少术中出血量、术后引流量、住院时间和术后 VAS 疼痛评分,用于治疗腰椎管内肿瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/340f/8475735/427babb0226c/medscimonit-27-e931768-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/340f/8475735/83f82f418f73/medscimonit-27-e931768-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/340f/8475735/f1aa05aabcb8/medscimonit-27-e931768-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/340f/8475735/427babb0226c/medscimonit-27-e931768-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/340f/8475735/83f82f418f73/medscimonit-27-e931768-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/340f/8475735/f1aa05aabcb8/medscimonit-27-e931768-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/340f/8475735/427babb0226c/medscimonit-27-e931768-g003.jpg

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