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经侧块螺钉固定椎板切除术治疗颈椎神经鞘瘤的临床效果:一项回顾性研究。

Clinical Effect of Laminectomy with Lateral Mass Screw Fixation in Treating Cervical Schwannoma: A Retrospective Study.

机构信息

Department of Spine Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China.

Department of Spine Surgery, The Second Hospital of Tangshan, Tangshan 063000, China.

出版信息

Biomed Res Int. 2022 Apr 29;2022:8512374. doi: 10.1155/2022/8512374. eCollection 2022.

Abstract

BACKGROUND

The objective of this study was to evaluate the clinical effectiveness and safety of laminectomy combined with lateral mass screw fixation in treating cervical intradural extramedullary schwannoma.

METHODS

We retrospectively collected and analyzed medical records of 38 patients who underwent resection of cervical intraspinal schwannoma between January 2012 and April 2019. Based on different surgical procedures, two groups were divided among all participants: laminectomy-only ( = 21) and laminectomy with instrumented fixation ( = 17); the minimum follow-up time was 1 year. The visual analogue scale (VAS) score and neck disability index (NDI) were utilized for pain assessment; the Japanese Orthopedic Association (JOA) score was carried out for the assessment of neurological impairment. Radiographic changes of Cobb angle were compared before and after the surgery.

RESULTS

Consequently, demographics were well matched in both groups, without any statistical difference ( > 0.05). Compared with preoperation, both surgical procedures significantly improved VAS, NDI, and JOA scores ( < 0.001), but no differences between them ( > 0.05). In terms of postoperative spinal instability/deformity, laminectomy-only caused more events than instrumented fixation, which is statistically significant ( < 0.001).

CONCLUSIONS

In summary, laminectomy with lateral mass screw fixation is an effective and safe approach to treat cervical intraspinal schwannoma, which is likely to be a better choice than the laminectomy-only approach.

摘要

背景

本研究旨在评估椎板切除术联合侧块螺钉固定治疗颈椎髓外硬膜内 schwann 瘤的临床疗效和安全性。

方法

我们回顾性收集并分析了 2012 年 1 月至 2019 年 4 月期间接受颈椎椎管 schwann 瘤切除术的 38 例患者的病历。根据不同的手术方法,将所有参与者分为两组:单纯椎板切除术( = 21 例)和椎板切除术联合器械固定( = 17 例);最短随访时间为 1 年。采用视觉模拟评分(VAS)和颈部残疾指数(NDI)评估疼痛;采用日本矫形协会(JOA)评分评估神经功能障碍。比较手术前后 Cobb 角的影像学变化。

结果

两组患者的一般资料无统计学差异( > 0.05)。与术前相比,两种手术方法均显著改善了 VAS、NDI 和 JOA 评分( < 0.001),但两组之间无差异( > 0.05)。在术后脊柱不稳定/畸形方面,单纯椎板切除术比器械固定术发生的事件更多,具有统计学意义( < 0.001)。

结论

综上所述,椎板切除术联合侧块螺钉固定治疗颈椎髓外硬膜内 schwann 瘤是一种有效且安全的方法,可能比单纯椎板切除术更具优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da49/9076331/155bd4247d62/BMRI2022-8512374.001.jpg

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