摘要： 目的 探讨小切口半椎板入路显微手术切除椎管内肿瘤之优缺点。方法 回顾分析2008 年8 月-2013 年4 月采用小切口半椎板入路手术切除椎管内肿瘤患者的临床资料。结果 共19 例患者，肿瘤均全切除，病理分型分别为神经鞘瘤（12 例）、神经纤维瘤（1 例）、脊膜瘤（5 例）和血管母细胞瘤（1 例）。术后患者症状与体征明显改善，随访6 ~ 60 个月无一例肿瘤复发或出现脊柱失稳并发症。术中测量获得半椎板切除可显露胸腰椎骨窗面积为（15 ± 2）mm ×（32 ± 5）mm。结论 采取小切口半椎板入路显微手术切除椎管内肿瘤，创伤小、有利于维持脊柱稳定性，而且患者术后住院时间短、反应轻微、远期疗效良好，但对手术技术要求较高。

关键词: 脊髓肿瘤, 椎管, 椎板切除术, 显微外科手术

Abstract: Objective  To evaluate the advantages and disadvantages of unilateral hemilaminectomy for the microsurgical removal of intraspinal tumors. Methods Clinical data of 19 patients with intraspinal tumors were analyzed from August 2008 to April 2013. All cases were treated microsurgically using unilateral hemilaminectomy procedures.  Results  Tumors were totally removed in all patients, including 12 cases of schwannoma, 1 case of neurofibroma, 5 cases of spinal meningioma and 1 case of hemangioblastoma. After operation signs and symptoms of every patient were significantly improved. Postoperative follow-up period was 6-60 months. No recurrence and spinal instability were found. The average area of intraoperative unilateral hemilaminectomy was (15 ± 2) mm × (32 ± 5) mm.  Conclusion  Unilateral hemilaminectomy for the removal of intraspinal tumors is a mini-invasive procedure, and is beneficial to the stability of spine, with the advantages of short hospitalization time, slight postoperative reaction and good long-term outcome. However, the procedure requires a skilled technology.

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