后正中入路Dynesys置入对腰椎全椎板减压术后生理性稳定性的作用

Dynesys placement on lumbar spine stability during total lumbar laminectomy decompression via posterior midline approach

目的探讨经后正中入路切除腰椎椎管内神经鞘瘤同时行腰椎动态稳定重建系统(Dynesys)置入对重建脊柱生理性稳定的作用。方法对采用后正中入路全椎板切除上腰椎椎管内神经鞘瘤的6例患者,术后应用腰椎Dynesys进行脊柱稳定性重建。结果神经鞘瘤均完整切除。术后1周、3个月、6个月时X线片复查示腰椎过伸、过屈位各椎体活动度良好,椎间隙等宽;内置物位置良好,无临近节段退变、脊柱失稳、椎体滑脱现象。结论对腰椎椎管内神经鞘瘤采用全椎板切除后置入Dynesys能够充分暴露肿瘤所在区域的视野,完整切除神经鞘瘤,有效避免损伤脊髓神经。Dynesys既能达到传统强直融合的脊柱稳定性,还能够有效重建生理性稳定,防止临近节段脊椎发生退变。

Objective To investigate the role of Dynesys placement on lumbar spine stability during the total lumbar laminectomy decompression for intraspinal schwannoma via posterior midline approach Methods 6 patients with lumbar intraspinal schwannoma were underwent by the total laminectomy via posterior midline approach .After the operation , the lumbar spinal stability was rebuilt by Dynesys placement .Results Schwannoma were completely resected . The X-ray reexamination in 1 ,3 ,6 months showed the activitivies of each vertebral flexion were good including L-spine flexion-extension position and the width of intervertebral space were equal .Implants location was good without adjacent segment degeneration , spinal instability and spondylolisthesis . Conclusions Dynesys placement during total laminectomy resection for lumbar spine intraspinal schwannoma can fully expose tumor area field of vision , completely remove schwannoma , effectively avoid spinal cord injury .Dynesys placement can not only achieve the traditional fusion stiffness of spinal stability , but also can effectively rebuild the physiologic stability and prevent the adiacent segment degeneration .