Abstract:

Objective 　To investigate the clinical effect of using percutaneous tubular retractor system on microsurgical resection of lumbar intraspinal cysts via unilateral hemilaminectomy.　Methods　We performed a retrospective analysis of the clinical data of 13 patients with lumbar intraspinal cysts treated via a unilateral hemilaminectomy approach using percutaneous tubular retractor system from June 2014 to January 2018, including synovial cyst (n=5), ganglion cyst (n=3), meningeal cyst (n=3) and epithelioid cyst (n=2). Clinical outcomes were assessed using the visual analog scale (VAS) and the Japanese Orthopedic Association (JOA) scale. Computed tomography (CT) three-dimensional reconstruction of lumbar vertebrae was performed l week postoperatively, MRI plain scan and enhanced scan of lumbar vertebrae were conducted during  the follow-up period.   Results　Mean operative time was 119.2 min (ranging from 74 to 200 min). Mean blood loss during surgery was approximately 61.5 mL (ranging from 40 to 105 mL). The mean duration of hospital stay was 6.7 days (ranging from 5 to 10 days). Patients were followed-up for a period of between 4 months and 47 months, with a mean follow-up time of 23.8 months.  Complete resection was achieved in all patients without nerve root injury or cerebrospinal fluid leakage. Postoperative scores of VAS and JOA improved significantly versus preoperative ones(P<0.05). No postoperative spinal instability was identified by CT three-dimensional reconstruction of lumbar vertebrae, and no evidence of recurrence or secondary spinal deformity was observed in any patients during the postoperative follow-up period.　Conclusion　Unilateral hemilaminectomy approach using percutaneous tubular retractor system can be used to treat lumbar intraspinal cysts, such surgical procedures have characteristics of less trauma, faster recovery, reliable clinical effect and good postoperative spinal stability, which is worth of clinical promotion.

Key words: Lumbar intraspinal cyst; , Tubular retractor; , Minimally invasive surgery; , Hemilaminectomy