棘突椎板回植椎管成形在胸腰椎后路手术中的应用

Clinical evaluation of replantation of lamina and spinous process during laminoplasty in posterior thoracolumbar operation

目的探讨棘突椎板回植椎管成形在胸腰椎后路手术的应用价值。方法将43例患者(椎管内肿瘤患者8例,脑性瘫痪选择性脊神经前后根切断术35例)的带蒂棘突椎板行棘突内面纵形开槽,两侧椎板横形掰开,回植椎管成形。结果临床随访平均18个月,回植棘突椎板获得骨性融合,脊柱稳定性得到有效的保持,未发现椎管狭窄及椎管疤痕黏连压迫硬膜等手术后并发症。结论棘突椎板回植椎管成形可满足手术显露的要求,又保持了椎管的完整性,可以有效预防胸腰椎后路手术后疤痕增生黏连对椎管内脊髓神经的压迫。

Objective To evaluate the replantation posterior thoracolumbar surgery. Methods Forty-three of lamina and spinous process during laminoplasty in cases including 8 cases of spinal canal tumors, 35 cases of spastic cerebral palsy treated with selective partial anterior and posterior rhizotomy. After the spinous process was cut vertically, both sides of a lamina were separated horizontally and replanted. Results After 18 month follow-up, replanted lamina and spinous process of all cases got bony fusion and good stability, without spinal stenosis or compression owing to scar. Conclusion This method can provide good operative exposure, maintain the spinal integrity and avoid nerve root compression due to the spinal canal scar.