A modified unilateral hemilaminectomy approach for minimally invasive resection of extradural and subdural extramedullary space-occupying lesions
10.3760/cma.j.issn.1671-8925.2013.06.012
- VernacularTitle:经一侧半椎板入路微创手术切除椎管内硬脊膜外/下髓外病变
- Author:
Fang-You GAO
1
;
Qu WANG
;
Chuang-Xi LIU
;
Chao WANG
;
Cheng-Yong YANG
;
Jun MA
Author Information
1. 贵州省人民医院神经外科
- Keywords:
Hemilaminectomy;
Intraspinal lesion;
Minimally invasive surgery;
Outcome
- From:
Chinese Journal of Neuromedicine
2013;12(6):592-595
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the operative techniques for minimally invasive resection of extradural and intradural extramedullary space-occupying lesions and their values.Methods Twenty-six consecutive patients with intraspinal extramedullary lesions,admitted to and underwent modified unilateral hemilaminectomy in our hospital from August 2008 August 2012,were chosen in our study; there were 5 cases of extradural lesions,and 21 patients with intradural extramedullary lesions;their clinical data and treatment efficacy of these patients were retrospectively analyzed.Results Histologically,eleven lesions were determined to be sehwannomas,four spinal meningiomas,three enterogenous cysts,three herniated discs,two extradural ruptured and bleeding vascular malformations,one sub-adventitial hematoma of nerve root,one capillary hemangioma,and one metastatic neoplasm.All of 26 lesions were completely excised via the limited bone window following unilateral hemilaminectomy.Four spinal meningiomas of resections were assisted with contact laser systems; three enterogenous cysts of resections were assisted with endoscope.With respect to neurological status,all of 26 patients were markedly improved.There were no complications associated with this surgical technique.At the median 9.8-month-follow-up (3-36 months),21 of 26 patients returned to normal life and work.None of the subjects showed spinal deformity or instability and recurrence of the lesions by the evaluation of postoperative MRI and CT.Conclusion By preserving the musculoligamentous attachments and posterior bony elements of spine as much as possible,most of intraspinal lesions could be safely and effectively excised with the modified minimally invasive techniques; with assistance of contact laser system and endoscope,the total resection rate of intraspinal lesions and their outcomes would be improved.
