椎板单开门成形回植在选择性脊神经前后根切断术中的应用

Laminae split open and regrafting in SAR and SPR

目的探索椎板单开门回植成形在选择性脊神经前后根切断术(SAR或SPR)中的应用价值。方法在12具胸腰段脊柱标本上模拟手术行椎板单开门、内板及棘突纵行开槽、两侧椎板横行扮掰开，然后回植成形，分别测量成形前后的椎管横、矢径。选12具胸腰椎椎板成形的标本，用MTS－858实验机进行生物力学测试。结果成形术后的椎管内径均略大于术前。成形术后的椎板的所能承受垂直压应力是平均78.54kg，远远大于仰卧位时脊柱所需要承受的压应力。并将此椎板开门成形回植术应用于临床25例SAR和SPR手术中。临床随访平均2年6个月，效果良好，无脊柱不稳和椎管狭窄的症状、体征和影像学改变。结论椎板开门成形回植既满足了SAR和SPR手术的显露要求，保持了脊柱的稳定性，又不破坏脊柱的稳定性，值得提倡。

Objective To evaluate the clinical significance of Laminae split open and regrafting in SARand SPR.Method 12 specimen of thoracic Lumbar spine were operated with split open and regrafting , transverse diameter and arrow diameter of spinal canal were examined.Biomechanics of lamnioplastic spines were randomly tested with MTS－858 .Result The interal dimeter of spinal canal post operation is lager than that of preoperation .The pressure of the lamnioplastty speciman can support is 78.54kg.Results show the climcal effect was good ,laminaes had fused.It had no signs of spine instable ,spinal canal stenosis .Conclusion Nicrotraumatic effect was provided,by laminal split open and regrafting in SAR and SPR.The technique continue to stable the spine .