腰椎后路棘突椎板连接块取植术治疗腰椎间盘脱出症(附3例报告)

Remove - implantation of spnons process lamina by lumbar vertebrae posterior route for prolapse of lumber intervertebral disc. 3 cases report

研究一个新的手术方法,在手术治疗腰椎管内病变时,能有开阔的视野;能安全、彻底、有效地处理椎管内病变组织;不损伤主要韧带群;棘突椎板保持完整;保证脊柱稳定性;防止椎管内粘连。采取断骨不断韧带或少断韧带的方法,将病变区域的棘突椎板连接块整体取出,处理椎管内病变后整体回植。手术后患者腰椎管内病变解除,体征消失,拍X线片及CT显示棘突椎板连接块回植后骨连接良好,较术前无向前移位,无明显骨痂形成,未引起骨性椎管狭窄。通过本术式在三例手术中的应用,能较好的体现出在设计本术式时所要达到的标准;手术方法简单、安全,与传统术式用时相近;手术适应症较广泛。

To inveseigate a procedure which can widen the field of vision, savely, and effectively treat the lesion tissue in the vertebral canal without injuring the nain tendon group, maintain the integrity of spinous process limina, ensure hte stability of spinal column, and prevent vertebral canal abhesion in operating the lesion in lumbar vertebral canal. Sever the spinous lamina without breaking the tendons or only breaking tendons a little, move away the whole connecting piece of spinous lamina at the lesion region, treat the lesion in the verebral canal, and then implant the whole piece of the connecti-na, spinous process lamina. After operation, the patient's lesion in the lumbar vertebral canal is removed, the physical signs cannot be seen. Radiography and CT suggest that the bony union is good after implantation of the connecting piece of spinous process lamina. Comparing with pre - operation, on antedisplaccment is found. Porosis is not obvious. Bony vertebral canal stenosis is not induced. This operation was performed in three cases. The purpose of this operation was fairly achieved. The operation is simple and safe. The duration of this procedure is approximate to that of the traditional method. The indication of this operation is wide.