Posterolateral sulcus approach for spinal intramedullary tumor of lateral location: technical note.
Posterolateral sulcus approach for spinal intramedullary tumor of lateral location: technical note.
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DOI：
10.2176/nmc.tn2012-0419
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发表时间：
2013
影响因子：
1.9
通讯作者：
Ohata K
中科院分区：
文献类型：
--
作者：
Takami T;Yamagata T;Ohata K
脊髓后外侧沟入路与脊髓后根入路相当，如果应用得当，可以提供满意的脊髓髓内肿瘤暴露。本文报告了8例侧位脊髓髓内肿瘤患者经PLS入路手术治疗。有6名男性和2名女性患者，年龄范围为34 - 72岁（平均57岁）。PLS入路适用于位于脊髓外侧且术前磁共振（MR）图像上不接触后表面或侧表面的髓内肿瘤。除2例间变性星形细胞瘤外，其余6例肿瘤全切。所有6例肿瘤全切除的患者在手术后早期均表现出入路侧运动功能的中度或轻度恶化，并在手术后1个月内消退。术前改良McCormick功能量表平均评分为3.5，术后3个月改善为3.0。这6例患者在术后早期表现出令人满意的疼痛缓解。术前感觉疼痛评分平均为2.7，术后3个月改善至1.7。如果应用得当，PLS入路可作为脊髓髓内肿瘤的手术选择之一。PLS入路较好的适应证可能是脊髓内位置不均匀并伴有中度或重度局部疼痛的肿瘤。
Posterolateral sulcus (PLS) approach of the spinal cord, being equivalent to the dorsal root entry zone myelotomy, may offer the satisfactory exposure of the spinal intramedullary tumor if applied appropriately. Eight consecutive patients with spinal intramedullary tumors of lateral location underwent the surgery of PLS approach in our institute. There were 6 male and 2 female patients, ranging in age from 34 to 72 years (mean, 57 years). PLS approach was indicated for the intramedullary tumor situated laterally in the spinal cord and that do not contact the posterior or lateral surfaces on magnetic resonance (MR) images before surgery. Total removal of the tumor was achieved in 6 cases except of 2 cases of anaplastic astrocytoma. All 6 patients with total removal of the tumor demonstrated the modest or mild deterioration of motor function on the approach side early after surgery, which resolved within 1 month after surgery. Average grade of the modified McCormick functional schema was 3.5 before surgery and improved to 3.0 at 3 months after surgery. These 6 patients demonstrated satisfactory pain relief early after surgery. Average grade of the sensory pain scale was 2.7 before surgery and improved to 1.7 at 3 months after surgery. PLS approach can be one of the surgical choices to the spinal intramedullary tumors, if applied appropriately. Better indication for PLS approach may be the tumors of the uneven location within the spinal cord associated with moderate or severe local pain.