椎管内肿瘤切除椎管解剖重建

Anatomical reconstruction of spinal canal after intraspinal tumor resection

[目的]探讨椎管内肿瘤切除术中椎管解剖重建的临床效果。[方法]2013年2月—2017年5月,对48例椎管内肿瘤摘除后行中央钛板重建椎管。评价临床与影像结果。[结果]所有患者均顺利完成手术,无严重并发症,随访(35.8±13.6)个月。术后随时间推移,VAS与ODI评分显著减少(P<0.05),而ASIA评级显著改善提高(P<0.05)。影像方面,术后1周MRI见肿瘤均完全切除、硬脊膜减压充分。术后3个月CT三维重建见回植椎板骨质愈合良好,术后节段ROM及椎管面积较术前显著增加(P<0.05),无脊柱畸形、脊柱不稳或滑脱和肿瘤复发。[结论]椎管内肿瘤切除术中用中央钛板重建椎管可保持椎管容积,维持脊柱骨-韧带结构完整。

[Objective]To investigate the clinical outcomes of anatomical reconstruction of spinal canal after intraspinal tumor resec⁃tion.[Methods]From February 2013 to May 2017,48 patients underwent anatomical reconstruction of spinal canal with central piece plate secondary to intraspinal tumor resection.The clinical and imaging findings were evaluated.[Results]All the patients had operation complet⁃ed smoothly without serious complications,and were followed up for(35.8±13.6)months on an average.The VAS and ODI scores significant⁃ly decreased(P<0.05),while the ASIA neurological function grade significantly improved over time(P<0.05).Radiographically,all patients got tumors removed completely with sufficient dural decompression at 1 week after operation.Three months after operation,the CT three-di⁃mensional reconstruction showed that the re-implanted lamina healed well,and the segment ROM and spinal canal area significantly in⁃creased after operation(P<0.05),whereas no spinal deformity,spinal instability or spondylolisthesis and tumor recurrence were found in anyone of them.[Conclusion]Anatomical reconstruction of the spinal canal with central piece plate after intraspinal tumor resection does maintain the volume of the spinal canal and the integrity of the spinal bone-ligament structure.