McCormick P C
Columbia Presbyterian Medical Center, Neurological Institute, New York, New York, USA.
Neurosurgery. 1996 Jan;38(1):67-74; discussion 74-5. doi: 10.1097/00006123-199601000-00017.
The lateral extracavitary approach was used for single-staged tumor resection in 12 patients with complex dumbbell or paraspinal tumors of the thoracic and lumbar spine. Six women and six men (age, 28-72 yr) were treated between August 1990 and January 1994. The tumors included schwannoma (6 patients), malignant meningioma (1 patient), hemangioma (1 patient), chondrosarcoma (1 patient), osteocartilaginous exostosis (1 patient), radiation-induced osteogenic sarcoma (1 patient), and metastatic renal carcinoma (1 patient). Gross total resection was achieved in 11 patients. Radical subtotal removal was performed in the remaining patient, who had a malignant osteogenic sarcoma. Concomitant spinal stabilization with internal fixation and anterior interbody strut grafting was performed on two patients. No significant perioperative complications occurred. Ten patients were alive and clinically stable at follow-up visits ranging from 14 to 55 months. Two patients died from systemic tumor dissemination during the follow-up period. The lateral extracavitary approach is useful when extensive or difficult spinal and paraspinal exposure is required. The surgical aspects of these neoplasms and the technique of lateral extracavitary approach are described in detail.
采用外侧腔外入路对12例患有复杂哑铃型或胸腰椎旁脊柱肿瘤的患者进行一期肿瘤切除。1990年8月至1994年1月期间，共治疗了6名女性和6名男性（年龄28 - 72岁）。肿瘤包括神经鞘瘤（6例）、恶性脑膜瘤（1例）、血管瘤（1例）、软骨肉瘤（1例）、骨软骨瘤（1例）、放射性骨肉瘤（1例）和转移性肾癌（1例）。11例患者实现了肿瘤全切。其余1例患有恶性骨肉瘤的患者进行了根治性次全切除。2例患者同时进行了内固定脊柱稳定术和前路椎间支撑植骨术。围手术期未发生严重并发症。10例患者在随访14至55个月时存活且临床状况稳定。2例患者在随访期间死于全身肿瘤播散。当需要广泛或困难的脊柱及脊柱旁显露时，外侧腔外入路是有用的。本文详细描述了这些肿瘤的手术情况及外侧腔外入路技术。
