棘突椎板复合体原位回植在椎管肿瘤术中的应用

Clinical Application of Laminoplasty with Regrafted Lamina by Titanium Strip Fixation after Resection of Intraspinal Canal Tumors

目的探讨棘突椎板复合体原位回植在椎管肿瘤术中的意义。方法分析总结2008年2月至2011年4月间共24例椎管内肿瘤患者术中采用高速磨钻卸下椎板,处理完椎管内肿瘤后再将棘突椎板复合体原位回植,予钛条钛钉固定,恢复椎管正常解剖结构。结果所有病例未出现因高速磨钻卸下椎板,棘突椎板复合体原位回植固定而导致硬脊膜破损、脊髓和脊神经根损伤等并发症。随访3～24个月,未见回植组织移位、塌陷、畸形愈合及椎管狭窄症。结论椎管内肿瘤术中棘突椎板复合体原位回植,钛条钛钉固定的方法简便、实用,有利于恢复脊柱的正常解剖结构及稳定性。

Objective To explore the clinical value of laminoplasty with regrafted lamina by titanium strip fixation after resection of intraspinal canal tumors.Methods From February 2008 to April 2011,24 cases of intraspinal cancal tumors were treated with regrafted laminae by titanium strip fixation.During the operation,the spinous process and lamina complex was removed by the high-speed drill,and then was replanted in situ after the spinal cord tumor was resected,and was fixed by the titanium bar and titanium screw to restore the normal anatomy of the spinal canal.Results No patient appeared the complication due to the remove of the lamina by high-speed drill,nor to the spinous process and lamina complex in situ replantation.No damage caused for the epidural,spinal cord and spinal nerve root.During the 3 to 24 months follow-up,no replant tissue shift,nor collapse,malunion or spinal stenosis happened.Conclusion This technique is simple and practical in exposing the tumor of the spinal canal,and is reliable to restore the normal anatomy and stability of the spine.