Application of cavitron ultrasonic surgical aspirator in microsurgery of spinal lipoma surgery

doi:10.3877/cma.j.issn.2095-9141.2024.02.007

Abstract

Abstract:

Objective

To investigate the effect of cavitron ultrasonic surgical aspirator (CUSA) in spinal cord lipomas surgery.

Methods

A retrospective analysis was conducted on the clinical data of 10 patients with spinal lipoma who underwent CUSA at Neurosurgery Department of the Second Affiliated Hospital of Nanchang University from September 2020 to May 2023. McCormick grading method was used to evaluate the spinal cord function of patients before and after surgery.

Results

All 10 cases of lipomas were nearly completely removed. One month after surgery, 1 patient had spinal cord function improved, 9 patients were stable, no deterioration cases; Twelve months after surgery, 10 patients had spinal cord function improvement, no deterioration cases.

Conclusion

In the surgical treatment of spinal cord lipomas, the use of CUSA to remove intramedullary adipose tissue has the characteristics of convenient operation, high removal rate of intramedullary adipose tissue, and low risk of intraoperative spinal nerve function damage.

Key words: Spinal cord lipomas, Cavitron ultrasonic surgical aspirator, Microsurgery, Curative effect

Tong Zhou, Jian Zhan, Juexian Xiao, Shaohui Gong, Zujue Cheng. Application of cavitron ultrasonic surgical aspirator in microsurgery of spinal lipoma surgery[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2024, 10(02): 102-106.

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Figures/Tables 2

References 15

[1]	Morioka T, Murakami N, Suzuki SO, et al. Subpial lumbar lipoma associated with retained medullary cord[J]. NMC Case Rep J, 2021, 8(1): 51-55. DOI: 10.2176/nmccrj.cr.2020-0073.
[2]	Pang D, Zovickian J, Wong ST, et al. Surgical treatment of complex spinal cord lipomas[J]. Childs Nerv Syst, 2013, 29(9): 1485-1513. DOI: 10.1007/s00381-013-2187-4.
[3]	Pang D. Surgical management of complex spinal cord lipomas: How, why, and when to operate. A review[J]. J Neurosurg Pediatr, 2019, 23(5): 537-556. DOI: 10.3171/2019.2.Peds18390.
[4]	Pang D. Surgical management of complex spinal cord lipomas: a new perspective[J]. J Korean Neurosurg Soc, 2020, 63(3): 279-313. DOI: 10.3340/jkns.2020.0024.
[5]	Pang D, Zovickian J, Oviedo A. Long-term outcome of total and near-total resection of spinal cord lipomas and radical reconstruction of the neural placode, part II: Outcome analysis and preoperative profiling[J]. Neurosurgery, 2010, 66(2): 253-273. DOI: 10.1227/01.NEU.0000363598.81101.7B.
[6]	Lv H, Zhao H, Cai Y. Teaching neuroimage: lower limb muscle weakness due to intramedullary spinal cord lipoma[J]. Neurology, 2022, 99(16): 724-725. DOI: 10.1212/wnl.0000000000201167.
[7]	McCormick PC, Torres R, Post KD, et al. Intramedullary ependymoma of the spinal cord[J]. J Neurosurg, 1990, 72(4): 523-532. DOI: 10.3171/jns.1990.72.4.0523.
[8]	陈颖,罗晓宁,史文勇,等.超声手术刀的研制现状与应用[J].生物医学工程学杂志, 2005, 22(2): 377-380. DOI: 10.3321/j.issn:1001-5515.2005.02.038.
[9]	吴敏,汤黎明,刘铁兵,等.超声手术装置的原理及临床应用[J].医疗卫生装备, 2004, 25(10): 44-45, 48. DOI: 10.3969/j.issn.1003-8868.2004.10.023.
[10]	许鸣.全频超声乳化吸引刀的工作原理及临床应用[J].中国医学装备, 2008, 5(3): 34-35. DOI: 10.3969/j.issn.1672-8270.2008.03.013.
[11]	陈朝晖,吴水华.超声吸引装置在脂肪瘤型脊髓拴系综合征中的应用研究[J].临床小儿外科杂志, 2020, 19(2): 135-139. DOI: 10.3969/j.issn.1671-6353.2020.02.009.
[12]	Wykes V, Desai D, Thompson DN. Asymptomatic lumbosacral lipomas--a natural history study[J]. Childs Nerv Syst, 2012, 28(10): 1731-1739. DOI: 10.1007/s00381-012-1775-z.
[13]	Oi S, Nomura S, Nagasaka M, et al. Embryopathogenetic surgicoanatomical classification of dysraphism and surgical outcome of spinal lipoma: a nationwide multicenter cooperative study in Japan[J]. J Neurosurg Pediatr, 2009, 3(5): 412-419. DOI: 10.3171/2009.1.Peds08168.
[14]	鲍南,杨波,宋云海,等.预防性手术治疗儿童无症状脊髓脂肪瘤[J].中华神经外科杂志, 2019, 35(8): 771-775. DOI: 10.3760/cma.j.issn.1001-2346.2019.08.004.
[15]	修波,李萃萃,李文德,等.脊髓脂肪瘤的诊治策略[J].中华神经医学杂志, 2020, 19(7): 725-728. DOI: 10.3760/cma.j.cn115354-20200414-00274.

序号	性别	年龄（岁）	脂肪瘤部位	分型	首发症状	McCormick脊髓功能分级
序号	性别	年龄（岁）	脂肪瘤部位	分型	首发症状	术前	术后1个月	术后12个月
1	男	55	T5-9	背侧型	双下肢麻木、感觉减退	Ⅱ	Ⅱ	Ⅰ
2	男	5	L1-2	末端型	大便失禁	Ⅱ	Ⅱ	Ⅰ
3	女	34	L3-S3	混杂型	右下肢麻木	Ⅱ	Ⅱ	Ⅰ
4	女	20	S1-2	过渡型	左小腿肌肉萎缩伴无力	Ⅱ	Ⅱ	Ⅰ
5	女	24	S1-3	过渡型	小便失禁	Ⅱ	Ⅱ	Ⅰ
6	女	47	S2-3	过渡型	小便失禁伴尿储留	Ⅱ	Ⅱ	Ⅰ
7	女	53	L3-4	过渡型	右下肢疼痛、麻木	Ⅱ	Ⅱ	Ⅰ
8	女	30	S2-3	过渡型	左下肢无力	Ⅲ	Ⅱ	Ⅰ
9	女	25	S1-2	过渡型	腰痛伴双下肢乏力	Ⅱ	Ⅱ	Ⅰ
10	女	7	L4-S3	过渡型	小便失禁伴尿储留	Ⅱ	Ⅱ	Ⅰ

序号	性别	年龄（岁）	脂肪瘤部位	分型	首发症状	McCormick脊髓功能分级
序号	性别	年龄（岁）	脂肪瘤部位	分型	首发症状	术前	术后1个月	术后12个月
1	男	55	T5-9	背侧型	双下肢麻木、感觉减退	Ⅱ	Ⅱ	Ⅰ
2	男	5	L1-2	末端型	大便失禁	Ⅱ	Ⅱ	Ⅰ
3	女	34	L3-S3	混杂型	右下肢麻木	Ⅱ	Ⅱ	Ⅰ
4	女	20	S1-2	过渡型	左小腿肌肉萎缩伴无力	Ⅱ	Ⅱ	Ⅰ
5	女	24	S1-3	过渡型	小便失禁	Ⅱ	Ⅱ	Ⅰ
6	女	47	S2-3	过渡型	小便失禁伴尿储留	Ⅱ	Ⅱ	Ⅰ
7	女	53	L3-4	过渡型	右下肢疼痛、麻木	Ⅱ	Ⅱ	Ⅰ
8	女	30	S2-3	过渡型	左下肢无力	Ⅲ	Ⅱ	Ⅰ
9	女	25	S1-2	过渡型	腰痛伴双下肢乏力	Ⅱ	Ⅱ	Ⅰ
10	女	7	L4-S3	过渡型	小便失禁伴尿储留	Ⅱ	Ⅱ	Ⅰ

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