椎板成形术治疗椎管内疾病的研究进展

外科手术是治疗椎管内疾病的首选方法 ,手术方式有单纯椎板切除术和椎板成形术等。理想的椎管内手术既要充分显露椎管、完整切除占位并解除脊髓压迫,还要维持脊柱生物力学稳定性。由于临床医师对椎管内疾病手术过程中脊柱稳定性的保护与重建存在不同认识,手术方式的选择及如何保持脊柱生物力学的稳定性成为该领域研究的热点。为减少椎板切除对脊柱稳定性的影响,许多学者进行了积极的探索。椎板成形术可通过增加或重建椎管体积对脊髓进行直接减压并允许脊髓向背侧迁移离开椎间盘和椎体从而完成间接减压,既能做到术中充分显露和减压,又可防止脊柱术后失稳,除病变广泛、严重骨质破坏或合并骨质疏松外,是目前理论上单纯椎管内病变最理想的术式。

Progress on laminoplasty in spinal canal disease

Surgery is the preferred method for the treatment of spinal canal disease,surgical method involves laminectomy and laminoplasty. The ideal spinal surgery not only should fully expose the spinal canal,completely resect the occupied position and remove the spinal cord compression,but also should maintain the stability of spinal biomechanics. Because of the different realization of clinician to safeguard and rebuild the spinal stabilization during opertion of spinal canal disease,and choice of surgical method and how to maintain the stability of spine biomechanics has become a hot of research in this field. Many scholars have studied it in order to reduce the influence of laminectomy on the spinal stability. Laminoplasty can directly relieve the nerve roots compression caused by increasing or reconstruction of vertebral canal volume,and allow the migration of spinal cord to dorsum and depart from disc and vertebral body. Laminoplasty not only can fully expose and decompress during operative,but also may prevent the postoperative spinal instability. In addition to these condition of extensive disease,severe bone destruction or combined with osteoporosis,the laminoplasty is the most ideal method for single spinal canal disease in theoretically.