椎板及后韧带复合结构瓣回植治疗老年性腰椎管狭窄症

目的 探讨椎板及后韧带复合结构瓣回植治疗老年性腰椎管狭窄症的技术要点和疗效。方法 将部分腰背筋膜、棘上韧带、棘间韧带及椎板上骨膜保留，于病变节段下一椎间隙切断棘上棘间韧带，用骨刀(骨刀宽面与矢状面成角10-15度)在上下关节内侧2mm处自下而上并保持骨刀宽面进入椎板深度与椎板厚度相一致切断两侧椎板，牵开椎板及棘上棘间韧带，常规进行椎管减压，椎板及棘上棘间韧带回植。报告32例，男15例，女17例，年龄62-81岁，平均67．6岁。结果 32例均随访，最长6年，最短8个月，平均36个月。总优良率90．6％。结论 本术式显露范围广、椎管减压彻底，使椎管重新成形，有效的预防术后脊柱不稳、顽固性腰痛等并发症。

Treatment of lumbar vertebral canal stenosis by regrafting lamina and the compound structure of back ligament

Objective To explore the main points and clinical effect of the technique of regrafting the lamina and the compound structure of back ligamant for lumbar vertebral canal stenosis. Methods keep supraspinous ligament,interspinous ligament ,thoracolumbar and the periosteum of lamina.The supraspinous ligament and interspinous ligament was cut off below affected spinal canal. The lamina was cut off longitudinally with a chisel along the outside of lamina, detach ligament flavum bilaterally, and reverse upward lamina and the compound structure of back to open spinal canal. After performming expansive laminaplasty,the reversed lamina and the compound structure of back was regrafted. Results Thirty-two patients were followed up for 8 months to 6 years with an average of 3 years. The excellent and good rate was 90.6%.Conclusion The procedure has a wider opration space and a more thorough decompression,and prevents the complications of instability or intractable pain of the lumbar region.