卷帘式椎管扩大成形术41例报告

The roll-up-soreen type plastic operation of spinal canal enlargement

本文报告作者使用的一种能保留后柱完整的经后路椎管成形术。方法是将带角度的平凿将椎板从两侧斜行切断，连用棘上韧带、棘间韧带、棘突一起向上翻起，然后对椎管狭窄者行扩大成形，肿瘤者摘除病灶，去除病变后将椎板复位固定。临床使用41例近期效果满意。作者认为新手术有如下优点；①保持术后后柱完整，避免脊柱失稳。②减少硬膜周围疤痕形成。③器械简单，方法简便。作者强调：原有脊柱不稳者要作椎体间植骨，对椎管内肿瘤、凿开椎板时一定要小心仔细。

In this paper the authors ; porte that they used the posterior canalis vertebral fusion,that keeps posterior spine intact to reposition and fuse the vertebral lamina. By using an os teotome, set at a certain angle,the vertebral lamina is cut fromn both sides inwards. This all and of the supraspinal and interspinal ligaments, and spinal process, can then be turne over. The spinal canal stenosis can then be dilate,or an intraspinal tumour can be excised. Then the vertebral lamina can be repositioned and fuse. 41 cases who were treated though this met hod have shown satisfac tory results soon after the operation. The authors hol that the new fusion has many advantages: ①It can keep the posterior intact and prevent instability of the column. ②It can decrease the cica trization around dura mater. ③The netho,an instrucments used,are very simple. The authors also sterss that care should be taken: ①When implanting interspinous bone,in such cases where there is primary instability of the spine. ②When chiselling into the vertebral lamina,the surgieon must be careful of the intraspinal thmour.