腰椎板截骨再植术的长期随访

目的 探讨腰椎板截骨再植术的操作方法，评价其在预防术后腰椎不稳及硬脊膜外粘连的作用。方法1995年2月～2001年3月，收治腰椎管内病变患者169例，其中男96例，女73例。年龄22～63岁，平均49．7岁。病程6个月～6年，平均1年9个月。均有根性神经痛及间歇性跛行；CT示腰椎间盘突出和／或腰椎管狭窄。患者均施行椎板截骨敞开椎管处理病变，回植椎板椎管成形术。结果169例获随访5～9年，患者术后症状消失或缓解，脊柱活动良好。均无手术后并发症，原发病治疗效果良好。按王永惕等临床疗效标准评价疗效：优81例、良67例、可19例、差2例，优良率87．6％。腰椎X线片示脊柱稳定性良好，截骨再植椎板骨性融合；CT示椎管扩大成形良好，内面光滑。结论腰椎板截骨再植术是一种设计较为合理，操作简便的脊柱外科手术方式。

A LONG-TERM FOLLOW-UP OF LUMBAR LAMINOTOMY AND REPLANTATION

Objective To evaluate lumbar laminotomy and replantation in prevention of spinal unstability and peridural adhesion after laminectomy. Methods From February 1995 to March 2001,a total of 169 patients(96 males, 73 females,aged 22-63) with lesions in the lumbar vertebral canals underwent surgery, in which the lesions were removed after laminectormy and then the excised laminae were replanted. Results The follow-up for 5-9 years showed that all the patients had no complications after the lesions were removed. According to the evaluation criteria formulated by WANG Yongti,81 patients had an excellent result, 67 had a good result, 19 had a fair result, and 2 had a poor result. 87.6% of the patients obtained quite satisfactory results. The X-ray films demonstrated that the replanted laminae obtained bony healing and the spine was stable. The CT scanning demonstrated that the canals were enlarged with a smooth and glossy interior. Conclusion Lumbar laminotomy and replantation is reasonable in design and convenient in performance, which can be promoted as a basic operation in spinal surgery.