The Clinical Curative Effect Research On Operation Mode Of Cervical Intraspinal Extramedullary Tumor

Objective:To investigate the clinical curative effect of different operation methods of cervical intraspinal extramedullary tumors, and provide theoretical basis for treatment of cervical intraspinal extramedullary tumors. Methods: The clinical follow up data of 24 patients with intraspinal extramedullary tumor were retrospectively reviewed from February 2010 to December 2014. Surgical procedures were divided into two group;In group A,11 cases in the lateral tumor patients underwent semi-laminectomy and unilateral nail-rod system implanted and tumor resection;In group B,13 cases in the middle or large tumor patients underwent laminectomy and nail-rod system implanted and tumor excision;Complete resection rate and operation time and blood loss and Postoperative drainage and surgical complications and length of stay and Visual Analogue Scale (VAS) and Japan Orthopaedic Association (JOA) scoring criteria were applied after surgery. Results:All tumors were successfully resected. All postoperative pathology were schwannoma. In group A, The average operation time was 87.18±19.90min, the average amount of bleeding was 204.55±61.05ml, the average postoperative drainage was 345.45±151.15ml, the average hospitalization time was 15.82±3.12d,no postoperative complications in group A. In group B, the average operation time was 92.38±33.55min, the average amount bleeding was 565.38±146.32ml,, the average postoperative drainage was 615.38±442.24ml, the average hospitalization time was 19.67±12.40d; 4 cases of postoperative cerebrospinal fluid leakage in group B,3 cases were cured by conservative treatment,1 cases of incision healed after debridement and drainage.Two kinds of operation mode of the postoperative JOA score and VAS score compared with the preoperative have significant differences(p< 0.05); Patients were followed up for 1-48 months, two groups of patients with symptoms and signs were significantly improved, no spinal deformity, no tumor recurrence.Conclusion:According to the tumor in the cervical spinal position and size suitable operation method outside the tumor growth, when the tumor is located in the middle or large, We recommend total laminectomy and bilateral nail-rod system and tumor resection; when the tumor is smaller (diameter< 2cm) and growth in one side, We recommend hemilaminectomy and unilateral pedicle implantation and tumor resection.It is not only complete resection, reconstruction of spinal stability, and there is the advantages of less bleeding, less trauma and less postoperative cerebrospinal fluid leakage.