保留脊柱后韧带复合结构多椎板切除的临床应用

Preservation of the Posterior Complex Structures of the Lumbar Spinal Stenosis in Multiple Bilateral Laminectomy. A Clinical and Biomechanical Study

本文报道196例腰椎管狭窄症患者采用保留脊柱后韧带复合结构多椎板切除减压术。男121例,女75例。并通过生物力学方法评价其对腰椎稳定性的影响。实验结果表明:(1)多椎板切除减压术明显破坏腰椎的稳定性(p<0.01)。(2)保留脊柱后韧带复合结构将明显提高腰椎的抗弯强度(p<0.01和降低腰椎术后屈伸活动度(p<0.01)。(3)脊柱后韧带复合结构对维持腰椎的稳定,减轻术后腰椎过度屈曲和后凸畸形具有重要作用。本文还简介了该手术基本方法和临床效果,认为手术简单易行,安全有效,符合尽量减少后柱破坏的手术原则。

We neported preservation of the posterior complex structures in multiple bilateral laminectomy of the lumbar spinal stenosis in 196 cases,male 121 ,female 75. The biomechanical analysis of the stability of the lumbar spine was performed. The experimental results showed:1. The multiple bilateral laminectomy for lumbar spinal stenosis could destroy significantly the lumbar spinal stability (P<0. 01). 2. The strength against the bend of lumbar spine could be increased obviously(p<0.01)and the mobility of flexion-extension would be decreased greatly (P<0.01)by preaervation of the posterior complex structures 3. The posterior complex structures,especially the supraspinal ligaments and interspinal ligaments,would play an important role in maintaining the stability of the spine,preventing the hypermobility and lordosis of the lumbar spine. The operative methods and the clinical results were introduced. We found that the operation was very simple,secure and effective,worthy of the clinical use.