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Objective To explore the operative techniques for minimally invasive resection of extradural and intradural extramedullary space-occupying lesions and their values.Methods Twenty-six consecutive patients with intraspinal extramedullary lesions,admitted to and underwent modified unilateral hemilaminectomy in our hospital from August 2008 August 2012,were chosen in our study; there were 5 cases of extradural lesions,and 21 patients with intradural extramedullary lesions;their clinical data and treatment efficacy of these patients were retrospectively analyzed.Results Histologically,eleven lesions were determined to be sehwannomas,four spinal meningiomas,three enterogenous cysts,three herniated discs,two extradural ruptured and bleeding vascular malformations,one sub-adventitial hematoma of nerve root,one capillary hemangioma,and one metastatic neoplasm.All of 26 lesions were completely excised via the limited bone window following unilateral hemilaminectomy.Four spinal meningiomas of resections were assisted with contact laser systems; three enterogenous cysts of resections were assisted with endoscope.With respect to neurological status,all of 26 patients were markedly improved.There were no complications associated with this surgical technique.At the median 9.8-month-follow-up (3-36 months),21 of 26 patients returned to normal life and work.None of the subjects showed spinal deformity or instability and recurrence of the lesions by the evaluation of postoperative MRI and CT.Conclusion By preserving the musculoligamentous attachments and posterior bony elements of spine as much as possible,most of intraspinal lesions could be safely and effectively excised with the modified minimally invasive techniques; with assistance of contact laser system and endoscope,the total resection rate of intraspinal lesions and their outcomes would be improved.
RESUMO
<p><b>OBJECTIVE</b>To explore operative effect of lumbar intervertebral disc herniation accompanying with lumbar instability.</p><p><b>METHODS</b>Form June 2000 to June 2006, 46 patients of lumbar intervertebral disc herniation accompanying with lumbar instability were treated with decompression through posterior approach, diskectomy, spinal fusion and vertebral pedicle internal fixation. Including 33 males and 13 females,the age was from 37 to 68 years with an average of 48 years. The course of disease was from 4 months to 20 years with an average of 3.5 years. There were simple segment in 21 cases, double segments in 22 cases, three segments in 3 cases.</p><p><b>RESULTS</b>All patients were followed up for 12-45 months with an average of 25 months. All cases got solid fusion and clinical symptom improved obviously. According to clinical standard to evaluation, 32 cases obtained excellent result, 8 good, 6 fair. The rate of excellent and good was 86.9%.</p><p><b>CONCLUSION</b>Diskectomy, spinal fusion and internal fixation can obtain satisfactory clinical effect for lumbar intervertebral disc herniation accompanying with lumbar instability.</p>