腰椎管成形术在多节段腰椎管病变中的应用  

Application of Lumbar Vertiberal Canaloplasty to Multisegmental Lumbar Spinal Stenosis

作　　者：蓝朝晖 王雷舰 卢廷胜 林鹏 

机构地区：[1]解放军401医院骨二科,山东青岛266071 [2]青岛盐业职工医院骨科

出　　处：《中国伤残医学》2011年第6期1-3,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:研究腰椎管成形术联合椎弓根钉内固定系统,治疗双节段腰椎管狭窄症及腰椎管内肿瘤等复杂性腰椎管病变的手术技巧和临床疗效。方法:对2005年3月～2009年12月间,我院应用腰椎管扩大成形术,治疗双节段腰椎管狭窄症及腰椎管肿瘤患者共112例,其中双节段腰椎管狭窄症84例,腰椎管内良性肿瘤28例。结果:随访6个月～4年,本组术后优:87例,良:15例,优良率91.1%。结论:腰椎管成形术联合椎弓根钉内固定,同时关节突关节、棘突间动态固定治疗腰椎管病变,既能保持脊柱的即时稳定性,又保持了脊柱的持久稳定性,同时减少了腰椎生物力学改变,减少了术后骨质缺如和出血量,缩短了手术时间,对预防医源性椎管狭窄具有积极作用,对复杂而多节段腰椎管病变是一种较为理想的术式。Objective： To investigate the operation skill and therapeutic effect of lumbar larninoplasty with pedicle screw internal fixation system curing multi-segmental lumbar spinal diseases including two segmental lumbar spinal stenosis and lumbar spinal tumor etc. Methods： We had treated 112 patients sufferring from lumbar spinal stenosis or lumbar spinal tumor from March 2005 to December 2009, among which there were 84 two segmental spinal stenosis cases and 28 lumbar spinal bnigh tumor cases. Results： After 6 months to 4 years＇ follow-up, it is revealed that 87 cases had excellent result and 15 had good result. The good rate was 91.1%. Conclusion： There are many merits of lumbar laminoplasty with pedicle screw internal fixation system and simutaneous dynamic fixation of both the zygapophysial joints and the spinous processes in curing multi-segmental lumbar spinal diseases ,including obtaining not only immediate stability but lasting stability , less affecting the lumbar spine biomechanical properties , less post-operative bone defect and less bleeding and shorter operating time. It might be an ideal surgical method to cure the multi-segmental lumbar disease and should have an active role in preventing iatrogenic lumbar spinal stenosis.

关 键 词：腰椎管成形术 椎弓根钉 腰椎管狭窄症 动态固定 

分 类 号：R683[医药卫生—骨科学]