多颈段髓内肿瘤术后微型钛板重建椎管体会(附36例报告)  

The study on vertebral canal reconstruction with micro titanium plate after multi-cervical segments intramedullary tumor resection

作　　者：梁朝峰[1] 王辉[1] 李文胜[1] 石德金[1] 叶卓鹏[1] 秦峰[1] 郭英[1] 

机构地区：[1]中山大学附属第三医院神经外科,广州510630

出　　处：《中国神经精神疾病杂志》2009年第6期336-338,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的报道在多颈段髓内肿瘤显微手术中,应用桐田法切除整块椎板并以微型钛板固定回植,重建椎管的初步治疗经验。方法多颈段(>3节段)髓内肿瘤36例,均采用桐田法切除整块椎板,其中9例以微型钛板固定回植已切除的椎板,椎管成形,重建脊柱稳定性。结果经回植椎板行椎管成形的患者没有发现椎管狭窄、脊柱后突及不稳;未经回植椎板椎管成形病人中有6例出现脊柱后突畸形,3例出现呼吸障碍,5例出现括约肌功能障碍,6例出现脑脊液漏合并颅内感染,3例出现硬膜外积液。结论应用桐田法切除整块椎板并微型钛板固定,椎板回植,椎管成形,对多颈段髓内肿瘤切除术病人术后脊柱的稳定性意义重大,能减少术后并发症的发生。Objective To evaluate clinical therapeutic effect of vertebral canal reconstruction by Tomita method after multi-cervical segments Intramedullary tumor resection and vertebral plate replantation with titanium plate. Methods Tomita method was applied to remove the vertebral plate integritily in 36 case of multi-cervical segments （ 〉 3 ） Intramedullary tumor and vertebral canal reconstruction with micro titanium plate was used to keep spinal stability in 9 cases of them. Results Vertebral canal stegnosis, Kyphosis and spine unstability did not occur in patient with vertebral canal reconstruction. On contrast, Kyphosis occurred in 6 cases without vertebral canal reconstruction, respiratory disturbance, in 3 eases sphincter dysfunction in 5 cases, leakage of cerebrospinal fluid in 6 cases and epidural fluidify in 3 cases. Conclusions Application of Tomita method and replacement of vertebral plate to reconstruct vertebral canal are benefit the patient, especially in keeping spine stability and avoiding complications after multi-cervical segments intramedullary tumor resection.

关 键 词：多颈段髓内肿瘤 钛板 重建椎管 

分 类 号：R739.4[医药卫生—肿瘤]