保留椎弓连续性的有限椎管次环状减压术式的研究

The arcus vertebrae continuity remaining semicircular decompression therapy

目的为减少传统的椎管次全环状减压术所造成的脊椎结构破坏过多、导致脊柱不稳的发生,探索一种保留椎弓连续性的有限椎管次环状减压新术式。方法首先对T11～L3脊椎骨(脊柱骨折的好发部位)标本进行测量。得到可靠数据后,再进行临床操作。结果发现该段脊柱椎板与椎弓根的位置关系,完全不在同一平面上,且椎板有足够宽度,只需将椎板的上缘部分切除,即可显露椎弓根结构,经椎弓根达到椎体后缘的显露,再解除椎管前方的碎骨块压迫。结论椎管次环状减压术,无须按传统的方法破坏过多的脊柱后部的结构,使椎弓的环状完整性有效保留。保留椎弓连续性的椎管次环状减压术存在可行性,该术式既保留脊椎的稳定性,又达到了椎管减压彻底的目的。

Objective To explore a new surgical method of semicircular decompression, which compared to the traditional circular decompression method, might reduce the damage of posterior vertebrae structure; decreases the flabbiness of vertebra column; preserve the arcus vertebrae continuity. Methods Vertebrae specimens of T11 to L3 were measured, after carefully studied those reliable data, clinical operation were performed. Results The lamina arcus vertebrae and the pediculus arcus vertebrae that were measured were not on the same level, and the vertebral lamina is adequately wide. By merely remove the upper edge of the lamina arcus vertebrae, the pediculus arcus and the anterior vertebrae canal can be unveiled, and the pressure of the bone fragment in front of the vertebral canal could be easily removed. Conclusion The semicircular decompression therapy is not the same as the traditional ones that leads to too much damage of the posterior vertebrae structure. It can preserve the continuity of the vertebral lamina; keep the integrality of the vertebral arch. The vertebrae posterior structure remaining semicircular decompression is a reliable and practicable operation for the treatment of acut spinal injury. It can not only decompress the vertebrae canal completely but also avoid the flabbiness of vertebra column.