Intraspinal tumor resection is a kind of resection for the treatment of extradural, extramedullary, intradural, and intramedullary tumors. The methods of incision and lamina decompression, tumor resection, and posterior rhizotomy are used. It has the characteristics that elderly patients can tolerate the operation. Therefore, once people are diagnosed with intraspinal tumors, regardless of the degree of spinal cord compression, they should be treated in time. However, for those with high paraplegia and respiratory insufficiency, we should pay attention to the prevention and control of pulmonary infection, especially for the elderly.
People with symptoms and signs of spinal cord compression are confirmed as patients with space-occupying lesions in the spinal canal compressing the spinal cord through general examinations such as lumbar puncture, X-ray film, and special examinations such as myelography, CT scanning, magnetic resonance imaging, or spinal cord angiography.
1. Microsurgical techniques. Due to the use of headstock, the general cervical spinal cord extramedullary tumors can obtain good posture, and the application of advanced lighting equipment and bipolar electrocoagulation can reduce the difficulty of operation. However, due to the thick neck muscle and deep lesion site, the high cervical extraspinal tumor may damage the cervical spinal cord and important blood vessels, resulting in severe complications such as respiratory arrest. The application of Microsurgical techniques can prevent and reduce these complications. According to the MRI examination of the cervical spinal cord, the location and size of the incision can be determined.
2. Lamina fenestration is traditionally used for the removal of lumbar intervertebral disc nucleus pulposus. It is used for the removal of cervical intraspinal tumors. The purpose is to reduce the damage to the posterior structure of the vertebral body and maintain the stability of the spine after the operation. During the operation, the patient takes the prone position or lateral position. Unilateral laminectomy limits the bone window to one conical plate, the spinous process, supraspinous ligament, and interspinous ligament are preserved on the medial side and lateral facet preservation. No more than half of the lamina is removed by upper and lower biting. The window is opened from the lamina space, and the upper and lower distances are not more than half of the lamina. The length of the window can reach 15mm to 20mm and the width can reach 10mm to 15mm. The tumor can be removed in blocks or completely peeled out by the corresponding micro surgical instruments. If the longitudinal diameter of the tumor exceeds one segment, another window can be opened to remove the tumor. Because the operation field is relatively small, in order to avoid pulling and pushing the spinal cord, the tumor should be resected in situ. The common tumors in the spinal canal are schwannoma and meningioma. Most of them are small and can be removed by opening only one window.