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微型钛板腰椎管成形术在腰椎管狭窄症的应用 被引量:12

CANAL LAMINOPLASTY WITH TITANIUM MINIPLATE RE-IMPLANTATION OF VERTEBRAL LAMINA
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摘要 目的 探讨采用微型钛板腰椎管成形术在治疗腰椎管疾病应用中的安全性及有效性。方法2000年6月~2004年9月,收治腰椎管狭窄症患者18例,男10例,女8例,年龄28~56岁。病程3个月~3年。其中发育性腰椎管狭窄11例,退变性腰椎管狭窄7例。均伴腰椎间盘突出:L5、S1 6例,L4,5,9例,L3,4 2例,L3~5 1例;伴侧隐窝狭窄13例。应用微型钛板腰椎管成形术治疗,半侧椎板回植3例,全椎板回植14例,2个节段椎板回植1例。结果患者术后获随访3个月~4年3个月,平均1年8个月。术后症状缓解,无并发症发生,3~9个月后骨性融合。CT随访示无回植椎板移入椎管或移位倾向,无截骨前缘过度增生对硬脊膜产生新的压迫等,无明显椎间退变及椎间不稳;椎管矢状径扩大1.8~5.6mm,平均3.2mm;横径扩大1.3~4.4mm,平均1.8mm,症状无复发。结论微型钛板腰椎管成形术在腰椎管狭窄手术应用中安全可靠、疗效好,椎管扩大明显,椎板重建可靠,恢复了局部解剖和维持脊柱稳定。 Objective To evaluate the reliability and the advantage of canal laminoplasty with laminoplasty over laminectomy for treatment of lumbar spinal stenosis. Methods From June 2000 to September 2004, the titanium miniplate fixation technique was applied to re-implantation of the vertebral lamina in the lumbar spine. The vertebral lamina was made with a specially-made osteotome and a special technique in 18 patients with lumbar spinal stenosis. Results The patients were followed up for 1 yr and 8 mon on average (range, 3 mon-4 yr and 3 mon) and were observed to have a bony fusion of the re-implanted lamina 3-9 months postoperatively. There was no nonunion, displacement of the re-implanted lamina, overgrowth of the anterior bone edge of osteotomy, recompression of the nerves or instability of the lumbar spine. Conclusion The result demonstrates that canal laminoplasty with the titanium miniplate re-implantation of the vertebral lamina in lumbar spine can restore the normal anatomy, keep stability of the spine, and avoid adhesion and scar in the canal.
出处 《中国修复重建外科杂志》 CAS CSCD 北大核心 2006年第4期410-412,共3页 Chinese Journal of Reparative and Reconstructive Surgery
关键词 微型钛板 椎管成形 腰椎管狭窄 Titanium miniplate Canal laminoplasty Lumbar vertebral lamina
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