椎管内肿瘤显微切除术中椎板解剖学复位技术的应用

Clinical application of laminoplasty with regrafted lamina and spinous process after resection of intraspinal canal tumors by microsurgery

目的探讨椎管内肿瘤显微切除术中应用棘突椎板复合体解剖学复位回植椎管成形术中的应用价值。方法回顾性分析总结19例椎管内肿瘤患者术中采用铣刀椎板后路切开,处理完椎管内肿瘤后再将棘突椎板复合体原位回植,钛片固定,完成椎管成形。结果随访3～12个月,定期复查X线及MRI检查见棘突椎板复合体回植后达到解剖复位,未见回植物移位、塌陷,未见继发性椎管狭窄等并发症,回植局部无疼痛。16例显示椎板铣骨断面部分或完全融合,骨痂形成。结论椎管内肿瘤术中采用显微切除肿瘤,钛片钛钉固定棘突椎板复合体解剖学复位技术简便、安全、可靠,有利于脊柱的正常解剖结构及稳定性的恢复。

Objective To explore the clinical value of laminoplasty with regrafied lamina and spinous process by titanium strip fixation after resection of intraspinal canal tumors by microsurgery. Methods The clinical data of 19 patients who had spinal cord tumors and received laminotomy and vertebral canal reconstruction with regrafted laminae by titanium strip fixation was conducted, were analyzed retrospectively. 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 During the follow-up from 3 to 12 months, all patients were followed up with X-ray or MRI examination , no replant tissue shift, nor collapse, malunion or spinal stenosis happened. The regrafted region was synostosis in 16 cases and no pains. Conclusion This technique is simple , safe and practical in exposing the tumor of the spinal canal, and is reliable to restore the normal anatomy and stability of the spine .