微型钛板重建椎管方法在多节段颈椎髓内肿瘤切除术后的应用

Application of vertebral canal reconstruction with micro titanium plate after multi-cervical segmental intramedullary tumor resection

目的探讨微型钛板重建椎管方法在多节段髓内肿瘤切除术后应用的疗效。方法多节段髓内肿瘤24例,均采用桐田法切除整块椎板,其中7例以微型钛板固定回植已切除的椎板,重建椎管,保持脊柱稳定性。结果经回植椎板行椎管成形的病人没有发现椎管狭窄、脊柱后突及不稳;未经回植椎板椎管成形病人中有5例出现脊柱后突畸形,2例出现呼吸障碍,5例出现括约肌功能障碍,5例出现脑脊液漏合并颅内感染,3例出现硬膜外积液。结论应用桐田法切除整块椎板后微型钛板固定椎板回植法对多节段颈椎髓内肿瘤切除术病人术后脊柱的稳定性意义重大,能减少术后并发症的发生。

Objective To study the effects on vertebral canal reconstruction with micro titanium plate after multi-cervical segmental Intramedullary tumor resection.Methods The enbloc laminectomy was performed by Tomita method in the 24 cases with multi-cervical segmental intramedullary tumor.Among them,7 cases resected laminae were re-implanted with micro titanium plate fixation.The vertebral canal were reconstructed and spinal stabilited were kept.Results No vertebral canal stenosis,kyphosis and spinal unstability were found after laminal re-implantation and vertebral canal plasty.However,the kyphosis,respiratory disturbance,sphincter dysfunction,cerebral spinal fluid leakage associated with intracranial infection and epidural hydrops were in 5,2,5,5 and 3 cases respectively without laminae re-implantation and vertebral canal plasty.Conclusion After Tomita enbloc laminectomy,micro titanium plate fixed laminae re-implantation has keeping postoperative spinal stability for treatment of the patients with multi-cervical segmental intramedullary tumor and it would reduce the occurrence of postoperative complications.