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首页> 外文期刊>Neurosurgical focus >Comparison of open and minimally invasive surgery for intradural-extramedullary spine tumors
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Comparison of open and minimally invasive surgery for intradural-extramedullary spine tumors

机译：硬膜外硬脊膜肿瘤开放和微创手术的比较

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OBJECT Patients with symptomatic intradural-extramedullary (ID-EM) tumors may be successfully treated with resection of the lesion and decompression of associated neural structures. Studies of patients undergoing open resection of these tumors have reported high rates of gross-total resection (GTR) with minimal long-term neurological deficit. Case reports and small case series have suggested that these patients may be successfully treated with minimally invasive surgery (MIS). These studies have been limited by small patient populations. Moreover, there are no studies directly comparing perioperative outcomes between patients treated with open resection and MIS. The objective of this study was to compare perioperative outcomes in patients with ID-EM tumors treated using open resection or MIS. METHODS A retrospective review was performed using data collected from 45 consecutive patients treated by open resection or MIS for ID-EM spine tumors. These patients were treated over a 9-year period between April 2003 and October 2012 at Northwestern University and the University of Chicago. Statistical analysis was performed to compare perioperative outcomes between the two groups. RESULTS Of the 45 patients in the study, 27 were treated with the MIS approach and 18 were treated with the open approach. Operative time was similar between the two groups: 256.3 minutes in the MIS group versus 241.1 minutes in the open group (p = 0.55). Estimated blood loss was significantly lower in the MIS group (133.7 ml) compared with the open group (558.8 ml) (p The mean hospital stay was significantly shorter in the MIS group (3.9 days) compared with the open group (6.1 days) (p CONCLUSIONS Thoracolumbar ID-EM tumors may be safely and effectively treated with either the open approach or an MIS approach, with an equivalent rate of GTR, perioperative complication rate, and operative time. Patients treated with an MIS approach may benefit from a decrease in operative blood loss and shorter hospital stays.
机译：对象患有症状性硬脑膜外硬膜外（ID-EM）肿瘤的患者可通过病变切除和相关神经结构减压来成功治疗。对这些肿瘤进行开放切除的患者的研究报告了高总切除率（GTR），长期神经功能缺损最少。病例报告和小病例系列研究表明，这些患者可以通过微创手术（MIS）成功治疗。这些研究受到患者人数较少的限制。此外，尚无直接比较开放切除与MIS患者围手术期结局的研究。这项研究的目的是比较使用开放切除或MIS治疗的ID-EM肿瘤患者的围手术期结局。方法采用回顾性研究，该研究收集自45例接受开放切除或MIS治疗ID-EM脊柱肿瘤的连续患者的数据。自2003年4月至2012年10月，这些患者在西北大学和芝加哥大学接受了为期9年的治疗。进行统计学分析以比较两组之间的围手术期结果。结果在该研究的45例患者中，有27例采用MIS方法治疗，18例采用开放性方法治疗。两组的手术时间相似：MIS组为256.3分钟，开放组为241.1分钟（p = 0.55）。与开放组（558.8 ml）相比，MIS组（133.7 ml）的估计失血量显着降低（p与开放组（6.1天）相比，MIS组（3.9天）的平均住院时间明显缩短（结论结论胸腔ID-EM胸腔肿瘤可以通过开放手术或MIS手术安全有效地治疗，其GTR率，围手术期并发症发生率和手术时间相等，而MIS手术治疗的患者可受益于减少手术失血，住院时间短。

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