经两侧腰椎板间开窗分割切除椎体后缘大块骨赘的研究

Excision of the Hypertrophic Osteophyte in the Posterior Margins of Vertebral Body by Bilateral Symmetrical Fenestration of the Lumber Spine

1992年以来,采用自行研制的专用器械经两侧腰椎板间开窗分割切除椎体后缘大块骨赘21例,椎管横截面比术前平均扩大2.2倍,优良率达95.2％。该手术在较大程度上保留了腰椎后部结构的完整性,术后未发生腰椎不稳。在腰椎管前壁,椎内动脉前支与椎内静脉前丛共同围成一个以椎间盘为中心的“无血安全区”,在此区对椎体后缘骨赘施行分割切除,出血少,操作方便。本文对手术方法、指征及并发症预防进行了探讨。

Since 1992,21 cases of hypertrophic osteophyte in the posterior margins of vertebral body have been excised by bilateral symmetrical fenestration of lumbar spine. The postoperative cross-sectional area of the spinal canal is 2. 2 times larger than the preop-erative area in average,the rate of fine result is 95. 2%. After such operations.no instability of the lumbar spine occured.and the integrity of the posterior structure of the lumbar spine maintained to a great extent. In the anterior wall of the lumbar-spinal canal,there is a bloodless safe area surrounded by the intraspinal arterial anterior branch and the intraspinal venous anterior plexus. In this area,we meet with fewer bleeding and have a good incising in the course of operation. This article the method and the indication of the operation,as well as the prevention of complications.