摘要
目的探讨棘突椎板原位回植在椎管内肿瘤后路手术椎管重建中的作用。方法我院于2007年8月至2009年3月收治的11例椎管内肿瘤患者，在后路手术时采用肿瘤切除后棘突椎板复合体原位回植，用微钛片进行固定行椎板重建术。髓内肿瘤2例，髓外肿瘤9例；病变位于颈部2例，颈胸段4例，胸段2例，胸腰段2例，腰段1例。随访6—24个月，复查术区疼痛、椎管畸形及骨性愈合等情况。结果11例患者未发生因椎板重建所导致的硬脊膜、神经根及脊髓的损伤；1例存在术区中至重度疼痛，2例存在轻度疼痛；未出现脊柱活动受限的病例，CT或X线检查未见椎管狭窄表现；9例椎板均有不同程度的骨性愈合，其中5例椎板完全愈合。结论椎管内肿瘤后路手术采用微钛片进行椎板重建，有助于恢复脊柱正常的生理结构，保持脊柱的稳定性，避免医源性椎管狭窄的发生，是一种值得推广的安全有效的技术。
Objective To evaluate the surgical technique of titanium miniplates in reconstruction of laminar roof after a posterior approach in intraspinal tumor surgery. Methods From August, 2007 to March, 2009, 11 patients underwent intraspinal tumor surgery with osteotomy and reconstruction of laminar roof, titanium miniplates were used for fixing in the re-implantation. There were 2 intramedullary tumors ,9 extramedullary tumors. The target of surgery was the cervical spine in 2 cases, the cervicothoracic spine in 4 cases, the thoracic spine in 2 cases, the thoracolumbar spine in 2 cases, and the lumbar spine in 1 cases. The patitens were followed up for 6 months to 2 years. Local pain,bony healing and spinal malformation were assessed. Results In the 11 patients, there was no case of dural, nerve root, or spinal cord injury due to laminar roof reconstruction. One patient complained of moderate to severe local pain during follow-up and 2 patients complained of occasional slight pain at the surgical site. No limitation of activity occurred. Bony healing was confirmed radiologically or CT scan in 9 patients. There were no patients demonstrated a new spinal malalignment, and no patients developed stenosis of the spinal canal. Conclusions The reconstruction of the laminar roof using titanium miniplates will benefit the recovery of normal structure of spine, and maintain the stability of spine, and avoid the occurrence of stenosis of the spinal canal.
出处
《中国综合临床》
2010年第9期975-977,共3页
Clinical Medicine of China
关键词
椎管内肿瘤
椎板重建
微钛片
Intraspinal tumor
Reconstruction of laminar roof
Titanium miniplates
