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目的探讨成人椎管内肿瘤术中棘突椎板切开复位术应用效果。方法经后正中入路行椎管内肿瘤切除18例,术中将相应病变节段棘突、棘上韧带、棘问韧带、椎板整体切割取下,切除椎管内肿瘤后,整体原位回植棘突椎板,钛片-钛钉固定,完成椎管成形。结果 18例病人中棘突椎板切开复位节段2～6节段(平均3.8节段),肿瘤全切17例,全切率94.4%。所有病例术野显露满意,脊髓或神经根损伤均未加重,术后7～10 d摄X线片观察,棘突椎板均恢复原位连续性。随访复查MRI、X线片,回植的组织均无移位,全部骨性愈合。结论该术式解剖性地重建椎管结构,术后能保持脊柱的稳定性,减少术后并发症的发生。
Objective To investigate the effect of open reduction and reduction of spinous process laminoplasty in adult spinal canal tumor. Methods 18 cases underwent resection of intraspinal canal tumor via posterior midline approach. The corresponding lesion segments spinous process, supraspinous ligament and spine ligament were removed during operation. The entire lamina were removed and resected. After resection of the tumor in the spinal canal, Transplantation of spinous process lamina, titanium - titanium nail fixation, complete spinal canal formation. Results 18 cases of patients with spinous process laminoplasty incision and reduction of 2 to 6 segments (average 3.8 segments), 17 cases of complete resection of the tumor, total resection rate of 94.4%. All cases showed satisfactory surgical field, spinal cord or nerve root injury did not aggravate, 7 ~ 10 d after radiography X-ray observation, spinous process lamina were restored in situ continuity. Follow-up review of MRI, X-ray films, replantation of the organization no shift, all bony healing. Conclusions This procedure anatomically reconstructs the spinal canal structure and maintains the stability of the spine and reduces the incidence of postoperative complications.