北京大学学报（医学版）2024，Vol.56Issue(2)：318-321,4.DOI:10.19723/j.issn.1671-167X.2024.02.018
微通道技术在颈椎管肿瘤微创切除术中的应用
Application of microchannel technique in minimally invasive resection of cervical intraspinal tumors
摘要
Abstract
Objective:To explore the application and key points of microchannel approaches in resec-tion of cervical intraspinal tumors.Methods:A retrospective analysis was performed on 51 cases of cervi-cal spinal canal tumors from February 2017 to March 2020.Among them,5 cases were located epidural space,6 cases were located epidural and subdural space,and 40 cases were located under the subdural extramedullary space(6 cases were located on the ventral side of the spinal cord).The maximum diameter ranged from 0.5 to 3.0 cm.The clinical manifestations included neck,shoulder or upper limb pain 43 cases,sensory disturbance(numbness)in 22 cases,and limb weakness in 8 cases.The micro-channel keyhole technique was used to expose the tumor,and the tumor was resected microscopically.Results:In this study,35 patients underwent hemilaminectomy,12 patients underwent interlaminar fenestration,2 patients underwent medial 1/4 facetectomy on the basis of hemilaminectomy or interlaminar fenestration.Two tumors were resected through anatomy space(no bone was resected).The degree of tumor resection included total resection in 50 cases and subtotal resection in 1 case.The type of the tumor included 36 schwannomas,12 meningiomas,2 enterogenic cysts and 1 dermoid cyst.There was no infec-tion and cerebrospinal fluid leakage postoperatively.Limb numbness occurred in 7 patients.The average follow-up time was 15 months(3 to 36 months).No deformity such as cervical instability or kyphosis was found.The tumor had no recurrence.Conclusion:The cervical spinal canal is relatively wide,cervical tumors with no more than three segments can be fully exposed by means of microchannel technology.Besides intramedullary or malignant tumors,they can be microsurgically removed.Preservation of the skeletal muscle structure of cervical spine is beneficial to recover the anatomy and function of cervical spine.The electrophysiological monitoring helps to avoid spinal cord or nerve root injury.关键词
微通道/椎板间开窗/半椎板切除术/选择性椎板切除术/颈椎管肿瘤/稳定性Key words
Microchannel/Interlaminar fenestration/Hemilaminectomy/Selective laminectomy/Cer-vical intraspinal tumor/Stability分类
医药卫生引用本文复制引用
林国中,马长城,吴超,司雨,杨军..微通道技术在颈椎管肿瘤微创切除术中的应用[J].北京大学学报（医学版）,2024,56(2):318-321,4.基金项目
首都临床特色应用研究项目(Z171100001017120)、国家自然科学基金(81601200)和北大医学青年科技创新培育基金(BMU2022PY008)Supported by the Capital Foundation for Clinical Characteristics and Application Research(Z171100001017120),the National Natural Science Foundation of China(81601200),and the Peking University Medicine Fund of Fostering Young Scholars'Scientific & Technological Innovation(BMU2022PY008) （Z171100001017120）
