异体脱钙骨片重建椎板的临床应用

目的：试用异体半脱钙股骨片重建椎板,预防与减少全椎板切除后的并发症。方法：对１８例节段性腰椎管狭窄症,其中１０例合并椎间盘突出的病例行业全椎板切除,并用异体半脱钙骨片根据椎板切除范围（１～１．５个椎板）进行设计。Ｈ型覆盖,与上下椎板相连,并用缝线加以固定,同时紧密缝合两侧骶棘肌。结果：术后随访０．５～３年,１５例患者恢复原来的工作和生活。症状体征基本消失。３例虽有轻度腰或腿痛,但比术前明显好转。无明显的排异反应。ＣＴ和ＭＲ显示腰椎管扩大,椎板无移位。脊髓无压迫。２年后异体椎板已完全被自体骨替代。结论：异体半脱钙骨是一种良好的重建材料,在节段性（１～１．５个）椎板重建中,效果较为满意。

Clinical Application of Repairing Vertebral Lamina Using Homogeneous Decalcifying Bone

Objective:To observe clinical results of reconstruction of vertebral lamina with homogeneous decalcifying bone in laminectomy.Methods:Eighteen cases of segmental lumbar vertebral stenosis,including1 0 cases of lumbarinterbody disc protrusion,underwentlaminectomy and the clinical results were observed.The extent of laminectomy was about1 -1 .5lamine. Homogeneous decalicifying bone sized by the range of laminectomy was covered by " H" type, connected to the laminas and fixed by suture,and the bilateral sacrospinal muscles were tight sutured.Results:The follow-up was from6 months to3 years.Fifteen patients improved in health and restarted their occupations and normal life.Three patients complained to have lumber or leg pain,but they felt better than before operation.There was no rejection in the application.On the CT and MRI films,lumbar vertebral canal was confirmed to be enlarged.L aminae did not move, and spinal cord was not pressured. Two years later,homogeneous laminae were replaced completely by the autogenous bone.Conclusion:Homogeneous decalcifying bone is an ideal and safe material for lamina reconstruction,and can be used in segmental laminectomy.