经左侧半椎板入路行T3-4脊膜瘤全切除术
经左侧半椎板入路行C2-3神经鞘瘤全切除术视频：椎管内外沟通性“哑铃”形肿瘤显微手术治疗策略
Topic: Surgical strategy for intra- and extra-vertebral dumbbell-shaped tumors
作者：孙力泳，陈赞，陈永杰，吴浩，菅凤增
Authors: SUN Li-yong, CHEN Zan, CHEN Yong-jie, WU Hao, JIAN Feng-zeng
原文链接：中国现代神经疾病杂志,2013,13(12):988-994
Associated with: Chinese Journal of Contemporary Neurology and Neurosurgery, 2013, 13(12):988-994
视频1：女性患者，32岁。主因胸背部疼痛6个月入院。查体：双下肢肌力5级，病理征阳性。MRI显示，T3～4椎体占位性病变，增强扫描病灶呈明显均匀强化，可见“硬膜尾征”。经左侧半椎板入路全切除肿瘤。
旁中线剪开硬脊膜，显露肿瘤，肿瘤表面附有蛛网膜。
电凝肿瘤基底，分块切除肿瘤。
悬吊齿状韧带，轻度翻转脊髓，增加对腹侧肿瘤的显露。
切除肿瘤附着处的硬脊膜内层，以减少肿瘤复发。
Video 1: A 32-year-old female suffered from pain of chest and back and came to clinic. MRI showed T3-4 space-occupying lesion with homogenous enhancement and dural tail sign. Left hemilaminectomy was performed to excise the tumor.
Spinal dural mater was cut open through paramedian line to expose the tumor, which was covered by arachnoid.
The tumor base was performed electrocoagulation and the tumor was performed piecemeal resection.
Suspend denticulate ligament and turn the tumor mildly to increase the exposure of tumor in ventral spinal cord.
Remove inner layer of spinal dural mater which was attached by the tumor, in order to prevent tumor recurrence.
视频2：男性患者，73岁。主因左肩部疼痛、伴左臂麻木1年入院。查体无特殊。MRI显示，C3～4椎体占位性病变，呈长T2信号，沟通于C3～4椎间孔。采取左侧半椎板入路全切除肿瘤。
咬开C2～3左侧小关节，显露左侧神经根袖套。
旁中线剪开硬脊膜，显露椎管内肿瘤部分，分块切除。
剪开神经根袖套，显露椎管外肿瘤部分，分块切除。
严密缝合硬脊膜。
Video 2: A 73-year-old male suffered from pain of left shoulder and left hand numbness for 1 year. MRI showed that T3-4 space-occupying lesion with high density in T2WI communited inside and outside of vertebral canal through T3-4 foramen. Left hemilaminectomy was performed to excise the tumor.
C2-3 left facet joint was cut open to expose left nerve root sleeve.
Spinal dural mater was cut open through paramedian line to expose the inside tumor and perform piecemeal resection.
Cur open nerve root sleeve to expose the outside tumor and perform piecemeal resection.
Suture spinal dural mater tightly.
Topic: Surgical strategy for intra- and extra-vertebral dumbbell-shaped tumors
作者：孙力泳，陈赞，陈永杰，吴浩，菅凤增
Authors: SUN Li-yong, CHEN Zan, CHEN Yong-jie, WU Hao, JIAN Feng-zeng
原文链接：中国现代神经疾病杂志,2013,13(12):988-994
Associated with: Chinese Journal of Contemporary Neurology and Neurosurgery, 2013, 13(12):988-994
视频1：女性患者，32岁。主因胸背部疼痛6个月入院。查体：双下肢肌力5级，病理征阳性。MRI显示，T3～4椎体占位性病变，增强扫描病灶呈明显均匀强化，可见“硬膜尾征”。经左侧半椎板入路全切除肿瘤。
旁中线剪开硬脊膜，显露肿瘤，肿瘤表面附有蛛网膜。
电凝肿瘤基底，分块切除肿瘤。
悬吊齿状韧带，轻度翻转脊髓，增加对腹侧肿瘤的显露。
切除肿瘤附着处的硬脊膜内层，以减少肿瘤复发。
Video 1: A 32-year-old female suffered from pain of chest and back and came to clinic. MRI showed T3-4 space-occupying lesion with homogenous enhancement and dural tail sign. Left hemilaminectomy was performed to excise the tumor.
Spinal dural mater was cut open through paramedian line to expose the tumor, which was covered by arachnoid.
The tumor base was performed electrocoagulation and the tumor was performed piecemeal resection.
Suspend denticulate ligament and turn the tumor mildly to increase the exposure of tumor in ventral spinal cord.
Remove inner layer of spinal dural mater which was attached by the tumor, in order to prevent tumor recurrence.
视频2：男性患者，73岁。主因左肩部疼痛、伴左臂麻木1年入院。查体无特殊。MRI显示，C3～4椎体占位性病变，呈长T2信号，沟通于C3～4椎间孔。采取左侧半椎板入路全切除肿瘤。
咬开C2～3左侧小关节，显露左侧神经根袖套。
旁中线剪开硬脊膜，显露椎管内肿瘤部分，分块切除。
剪开神经根袖套，显露椎管外肿瘤部分，分块切除。
严密缝合硬脊膜。
Video 2: A 73-year-old male suffered from pain of left shoulder and left hand numbness for 1 year. MRI showed that T3-4 space-occupying lesion with high density in T2WI communited inside and outside of vertebral canal through T3-4 foramen. Left hemilaminectomy was performed to excise the tumor.
C2-3 left facet joint was cut open to expose left nerve root sleeve.
Spinal dural mater was cut open through paramedian line to expose the inside tumor and perform piecemeal resection.
Cur open nerve root sleeve to expose the outside tumor and perform piecemeal resection.
Suture spinal dural mater tightly.
ISSN: 1672-6731