椎管肿瘤切除后椎板棘突复合体回植分节段固定重建脊柱稳定性的研究

目的探讨椎管肿瘤切除后椎板棘突复合体回植分节段固定的方法及临床疗效。方法 2006年6月～2008年8月,32例椎管肿瘤中18例行椎板棘突复合体回植并以钛网分节段固定。影像学研究通过术后复查X线片、CT等进行。结果 18例患者均获随访,随访时间6～28个月,平均14.6个月。16例患者均在术后1周内腰围保护下床活动,1例颈髓腹侧神经鞘瘤患者术后3个月神经功能恢复,1例圆锥畸胎瘤患者术后1个月可扶拐下地行走,其余患者出院时或痊愈或还有轻微局部疼痛或感觉障碍。所有患者术后复查影像学均未见脊柱失稳现象,植骨融合良好。结论此术式在切除椎管肿瘤时暴露充分,术后可重建椎管固定可靠,不限制脊柱活动度,减少术后脊柱不稳及加速退变等并发症,为摘除椎管内肿瘤较好的手术方法。

Study of spinal column stability reconstruction with regrafted lamina by segmented fixation after resection of intraspinal canal tumor

Objective To explore the way and clinical effects of regrafted lamina by segmented fixation after the excision of intraspinal canal tumor.Methods From June 2006 to August 2008,16 cases from 32 cases of intraspinal cancal tumor were treated with regrafted laminae by segmented fixation.All cases were followed up with X-ray or CT examination.Results All cases were followed up for 6～28 months,average 14.6 months.16cases could ambulate in one week postoperatively.1 case of neurinoma in the anterior site of crevical spinal cord recovered 3 months after operation,1 case of teratoma of spinal cone could walk.1 month after operation.No spinal Colum instability was detected through followed up imaging examination.The regrafted laminae fusion was good.Conclusion This technique is effective in exposing the tumor of the spinal canal,The reconstruction of the spinal canal is reliable.The spinal column active naturely without limit postoperatively,the technique can maintain the spinal column good stability and protect the spinal column from degradation.