椎板后移回植的椎管扩大术治疗椎管狭窄症

作者报告棘突劈开、椎板后移回植的椎管扩大术治疗椎管狭窄症１８２例，使椎管容积扩大３４．８％，横径扩大３．８ｍｍ，矢径扩大６．１ｍｍ。随访２年９个月，优良率８６．６％，椎板愈合率９６．９％。本文探讨少数椎板迟延愈合的原因和预防措施，如斜切椎板、缝合固定和腰背筋膜与棘上韧带悬吊缝合等。术后卧床１０～１２周，用石膏型保护。作者认为本法能有效的预防术后脊柱不稳，顽固性腰痛等并发症。

Treatment of Spinal Canal Stenosis by Split open the Spinous Process and Regrafting the Sectioned Laminae Posteriorly for Spinal Canal Enlargement

The technique of split open the spinous process and regrafting the sectioned laminae posteriorly for the treatment of 182 cases of spinal canal stenosis were reported.The mean volume of the spinal canal enlargement was 34.8%. The average enlargement of the transverse diameter was 3.8mm. The average sagittal diameter was enlarged in 6.1 mm. This series of cases was followed up for 6 months to 3 years and 8 months with an average of 2 years and 9 months. The total effective rate was 86.6%. The bony union rate of laminectomy were 96.9%. The preventive measures of nonunion after laminectomy consisted of oblique sectioning of the laminae, fixation of the bone flaps with sutures unto the fascia lumbodorsalis and supraspinal ligament . The patients were kept in beds of Plaster of Paris for 10 to 12 weeks after surgery to prevent the complications of instability or intractable pain of the lumbar region as well as prolapse of the intervertebral disks.