ABSTRACT
Objective To explore surgical techniques and curative effects of microsurgical treatment for tumors in upper cervical spinal canal.Methods A total of 81 cases of tumors in upper cervical spinal canal had received microneurosurgery from January 1990 to December 2005.The operation was conducted through a posteromedial approach.A total tumor resection was performed in 73 cases of neurofibroma or neurilemmoma,3 cases of spinal meningioma,and 3 cases of ependymoma.A subtotal tumor resection was conducted in 2 cases of astrocytoma.Results A complete recovery was achieved in 75 cases,an improvement of symptoms was achieved in 4 cases,and no improvement in 2.No death was encountered.Follow-up observations were carried out in 52 cases for 3 months ～ 3 years(8.5?1.5 months).MRI examinations 3 months after operation in 15 cases found no residual or recurrent tumor.X-ray radiography under anteroposterior,lateral,and open-mouth view 6 months after operation in 32 cases showed no spinal deformation and good vertebral stability.Recurrence of intramedullary tumor was seen in 3 cases. Conclusions As long as tumors in upper cervical spinal canal are diagnosed,a microsurgical treatment should be given as early as possible.Appropriate selection of surgical approach,skillful microsurgical techniques in accordance with pathological types of lesions,and principles of minimal invasion are critical for the operation safety.
ABSTRACT
Objective To investigate the long-term effects of microendoscopic discectomy for lumbar intervertebral disc herniation. Methods A retrospective analysis was made on 218 cases of lumbar intervertebral disc protrusion treated by microendoscopic discectomy. The Japanese Orthopedic Association (JOA) scoring system for lumbar myelopathy was used to evaluate surgical outcomes for each patient. Results All the patients were followed for more than 3 years postoperatively. Excellent outcomes were achieved in 121 cases, good in 80 cases, fair in 16, and poor in 1, the rate of excellent or good outcomes being 92.2% (201/218) . Conclusions Microendoscopic discectomy for lumbar intervertebral disc herniation has definitive long-term effects. Skillful surgical performance and proper postoperative rehabilitation training are crucial to good surgical outcomes.
ABSTRACT
Objective To explore the surgical techniques of keyhole approach craniotomy in the treatment of hypertensive intracerebral hemorrhage in old patients. Methods CT-guided keyhole approach craniotomy was performed to treat 50 old patients with hypertensive hematomas from January 2000 to August 2003. Results CT scans within 12 postoperative hours showed over 90% hematomas were removed. The activity of daily living (ADL) classification results 6 months after the surgery were: grade Ⅰin 10 cases (20.0%), grade Ⅱ in 21 cases (42.0%), grade Ⅲ in 9 cases (18%), grade Ⅳ in 3 cases (6.0%), grade Ⅴ in 2 cases (4.0%), and grade Ⅵ in 5 cases (10.0%). Conclusions Senility is by no means a contraindication for surgery in the treatment of hypertensive hematomas and keyhole approach minimally invasive craniotomy can give a satisfactory effect.