论文部分内容阅读
目的探讨原发性腰椎管内肿瘤切除手术中使用改良棘突椎板复合体回植的方法和效果。方法回顾2010年1月至2013年1月,我院收治的24例原发性腰椎管内肿瘤患者,术中用微型磨锯切断双侧椎板,保留双侧关节突,切断一侧棘上和棘间韧带,临时固定于一端,显微镜下摘除肿瘤,将带蒂棘突椎板复合体原位回植,选取微型钛板固定。术后采用影像学检查以及日本骨科学会(Japanese orthopaedic association,JOA)评定法进行效果评定。结果所有患者肿瘤成功切除,未出现脑脊液漏,无顽固性下腰痛,钛板固定可靠,回植椎板无塌陷,能有效融合。术后2年JOA评分由术前平均(11±2.6)分上升至(24±3.3)分,差异有统计学意义(P<0.05),术后优良率达83.3%。结论原发性腰椎管内肿瘤手术中应用改良带蒂棘突椎板复合体回植安全、有效,方法简单,重建了脊柱的解剖结构,维持了术后脊柱的稳定性。
Objective To investigate the method and effect of replantation of modified spinous process lamina in primary lumbar spinal canal resection. Methods From January 2010 to January 2013, 24 patients with primary lumbar spinal canal tumor admitted to our hospital were treated with micro-grinding sawing bilateral lamina, bilateral bilateral articular process was retained, and the side of the spine was cut off Interspinous ligament, temporarily fixed at one end, the tumor removed under the microscope, the pedicle spinous process laminar lamina back in situ, select the micro-titanium plate fixation. Postoperative imaging assessment and Japan orthopedic association (Japanese orthopedic association, JOA) assessment method for evaluation. Results All patients had successful resection of tumor, no leakage of cerebrospinal fluid and no intractable low back pain. Titanium plate was reliably fixed and non-collapse of replantation lamina could be effectively fused. The JOA score increased from (11 ± 2.6) points to (24 ± 3.3) points at 2 years after operation, the difference was statistically significant (P <0.05). The excellent and good rate was 83.3%. Conclusions The application of modified pedicle spinous process in the primary lumbar spinal surgery is safe, effective and simple. The anatomy of the spine is reconstructed and the postoperative stability of the spine is maintained.