椎板整块切除后回植椎管成形术在椎管内肿瘤中的应用

目的 探讨采用T-型锯进行椎板整块切除、回植椎管成形术在治疗椎管内肿瘤中的应用价值。方法 2000年7月-2002年12月,对17例椎管内肿瘤采用T-型锯将椎板整块锯下,切除肿瘤后将椎板原位精确回 植。平均随访1年,观察病人的神经恢复情况和影像学变化。结果 17例患者神经功能恢复良好,ASIA术前 评分3例为C,13例为D,1例为E,术后6个月均恢复到E,其中1例恶性肿瘤术后11个月因肿瘤复发神经症状 突然加重而再次手术。17例患者术后6个月再植椎板均愈合,没有发现骨质吸收、椎管狭窄、脊柱后突及不稳。 结论采用T-型锯将椎板整块切除后精确回植的椎管成形术,可恢复椎管正常解剖,操作安全,是一种新的治 疗椎管内肿瘤的手术方法。

Recapping Laminoplasty by Using T-Saw for Spinal Tumors

Purpose To evaluate the safety and efficacy of the recapping laminoplasty with T-saw for spinal tumors. Methods From July 2000 to December 2002,17 patients with spinal tumor underwent recapping laminoplasty with T-saw. The patients were followed for the neurologic recovery and bone healing. The mean follow up period was one year. Results All 17 patients recovered completely,except one patient with maligmant small round cell tumor recurred eleven months after the operation. The preoperation ASIA score was C in 3 patients,D in 13 patients, and E in 1 patient. All patients recovered to E within six month after operation. All the recapped lamina healed without bone resorption,spinal stenosis,kyphosis or instability, which was shown by CT scan. Conclusions Recapping laminoplasty with T-saw can provide precise anatomic reconstruction of the spinal canal with little risk,it's a new method to treat spinal tumor.