可复式椎板截骨显露法在SPR术中的应用

Application of Reducible Expose Laminotomy in SPR

目的设计可复式椎板截骨显露椎管开展选择性脊神经后根切断术(SPR),探讨其临床应用的可行性。方法自L2～S1各棘突、椎板的上1/3水平截骨,小关节突内缘两侧椎板向上凿开,将棘突、椎板、黄韧带向上掀起,显露椎管,节段切开硬脊膜行SPR术。结果治疗下肢痉挛性瘫17例,经7～18个月随访,无并发症发生。结论该术式不破坏脊柱的完整性,又便于SPR术的操作,能避免脊柱不稳和硬脊膜粘连等并发症的发生。

Objective To discuss the feasibility of reducible laminotomy exposure in SPR m clinical applications. Method To cut the lamina arcus vertebrae on upper 1/3 level from L2 to S1 acantha,chisel the lamina arcus vertebrae on inner edge of Little processus articularis upward and lift the acanthi, lamina arcus vertebrae, ligamentum flavum upward, the spinal cannel was exposed. Then the segmental endorachis was incised and SPR administrated. Result 17 cases of crura spastic paralysis were cured. 7-18 months follow up shew no neopathy. Conclusion The Operation doesn＇t damage the integrity of the spine. It is not only convenient for SPR but can avoid unstable spine and endorachis adherence.