腰椎板棘突复合体回植椎板交叉螺钉固定重建腰椎椎管的研究

目的探讨腰椎板棘突复合体回植椎板交叉螺钉固定在腰椎后路手术中的应用价值及疗效分析。方法1998年6月-2006年11月，800余例腰椎疾患患者中168例行腰椎后路减压手术时将椎板棘突复合体完整切下后保留，减压完成后将椎板棘突复合体回植，用交叉螺钉固定。随访137例，随访时间为6～88个月，平均23．6个月。影像学研究通过复查X线片、CT和／或三维重建进行。临床疗效按JOA评分评定。结果回植骨块位置良好，椎板螺钉固定佳。椎管内无明显狭窄，椎间小关节融合或椎板间骨性连接123例，骨融合率为89．78％，临床优良率为90．5％。结论此术式可以重建腰椎椎管，固定可靠，从而有效防治术后椎管内的瘢痕黏连。

Study of lumbar spinal canal reconstruction with regrafted laminae by screw in lumbar

Objective To evaluate the value and the clinical effect for the treatment of the severe lumbar disease with regrafted laminae by inter-screw.Methods From June 1998 to November 2006,168 patients with severe lumbar disease were treated with regrafted laminae by inter-screw fixtion.137 patients were followed up from 6 to 88 months(average 23.6 months)with X-ray examination.The improving rate of clinical effect were calculated with JOA score.Results Regrafted region and spinous process of 123 cases was synostosis,without spinal stenosision.Intervertebral fusion was 89.78%.Excellent and good treatments were 90.5%.Conclusion The technique can miantian the spinal integrity and good stability for the treatment of the severe lumbar disease.It is helpful in reducing the nerve root compression due to the spinal canal scar.