摘要
目的探讨后路椎板完整打开椎管内肿瘤切除后，复原椎板重建脊柱解剖结构的临床疗效。方法对2010年1月至2014年10月收治的32例椎管内肿瘤患者资料进行回顾性分析，男18例，女14例；年龄13-62岁，平均38岁；颈段椎管内肿瘤10例，胸段椎管内肿瘤14例，腰段椎管内肿瘤8例；所有患者均采用后路椎板开门或完整取下，椎管内肿瘤切除，复原椎板微型钛板固定，重建脊柱解剖结构。观察术后神经功能恢复情况，术前、术后脊柱活动度和椎管矢状径变化，脊柱稳定性及植骨融合情况。结果所有患者术后获3-23个月（平均13个月）随访。椎管内肿瘤均完整切除，术后神经功能Frankel分级均有不同程度改善。末次随访时所有患者脊柱活动度均位于正常活动范围内，未见明显受限。所有患者均取得植骨融合，内固定稳定，短期随访均未见脊柱滑脱、失稳等征象。末次随访时同一节段椎体对应椎管矢状径与术前比较差异无统计学意义（P〉0．05）。结论对于椎管内肿瘤，采用后路椎板开门或完整取下，椎管内肿瘤切除、椎板复位、微型钛板固定手术，一方面可清晰暴露椎管内占位，另一方面微型钛板固定、植骨融合椎板，重建了脊柱原有的解剖结构与功能，是一种理想的术式。
Objective To investigate the operative outcomes of anatomic and functional reconstruction of the spinal posterior column after resection of intraspinal neoplasms. Methods From January 2010 through October 2014, we treated 32 patients with intraspinal neoplasm in the spine. They were 18 men and 14 women, 13 to 62 years of age （average, 38 years）. The neoplasm was detected in the cervical spine in 10 cases, in the thoracic spine in 14 and in the lumbar spine in 8. All cases received expansive open door laminoplasty via the posterior approach for resection of the intraspinal neoplasm, followed by replantation and titanium plate fixation for anatomic and functional reconstruction of the spinal posterior column. The neural functional recovery, spinal motion and sagittal diameter of the spinal canal before and after operation, spinal stability and graft fusion were observed. Results The patients were followed up for 3 to 23 months （average, 13 months）. All the intraspinal neoplasms were completely resected. The Frankel grading of neural functional recovery was improved differently in all the cases. By the final follow-ups, the spinal motion was normal in all the cases, without any significant limitation. Graft fusion and rigid internal fixation were achieved in all the cases. Short-term follow-ups revealed no signs of spondylolisthesis or spinal instability. At the final follow-ups, the 3-D CT reconstruction showed no significant shortening in the sagittal diameter of the same spinal canal before and after operation （ P 〉 0.05） . Conclusions For intraspinal neoplasm in the spine, the whole vertebral lamina is opened or removed via the posterior approach to resect the neoplasm, followed by reduction of the vertebral lamina and mini titanium plate fixation to reconstruct the anatomy and function of the original spine. This is an ideal way to treat intraspinal neoplasms in the spine.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2016年第6期535-538,共4页
Chinese Journal of Orthopaedic Trauma
关键词
脊柱
修复外科手术
治疗结果
后路手术
Spine
Reconstructive surgical procedure
Treatment outcome
Posterior approach
