超声骨刀在脊柱椎板回植术中的应用  

Clinical application of piezosurgery in thoracolumbar intraspinal tumor with recapping laminoplasty

作　　者：丁超[1] 孙海燕[2] 王英胜[2] 孙中政[2] 郝其全[2] 王浩[3] 

机构地区：[1]潍坊医学院研究生院,261042 [2]解放军第89医院脊柱外科,261021 [3]安丘市人民医院脊柱科,山东潍坊262100

出　　处：《颈腰痛杂志》2015年第2期141-143,140,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨采用超声骨刀进行椎板整块切除、回植椎管成形术在治疗胸腰椎管内肿瘤中的应用价值。方法 2012-07-2013-07,对10例胸腰椎椎管内肿瘤采用超声骨刀将椎板整块锯下,切除肿瘤后将椎板原位回植联合钛板螺钉内固定方法重建胸腰椎后柱结构。平均随访1年,观察病人的神经恢复情况和影像学变化。结果所有患者切口均I期愈合。10例患者均获随访,术后平均随访时间约1年。术后3月复查胸腰椎CT及三维重建示回植椎板开始融合,胸、腰椎生理弧度可,无钛板螺钉松动、断裂等现象,胸腰椎MRI未见肿瘤复发,脊髓受压等。结论采用超声骨刀将椎板整块切除后回植的椎管成形术,可恢复椎管正常解剖,操作安全,是一种新的治疗胸腰椎管内肿瘤的手术方法 。Objective To evaluate the safety and efficacy of the recapping laminoplasty with piezosurgery for thoracolumbar intraspinal tumor. Methods From July 2012 to July 2013,10 pa- tients underwent intraspinal surgery with osteotomy and replacement of spinal laminae using piezosurgery and mini-plates to reconstruct the posterior structure of thoracolumbar spine. The mean follow-up period was one year,and the patients were followed for neurologic recovery and imaging changes. Results Operative incisions of 10 cases were all primarily healed. All of the patients were followed up and the mean follow-up period was one year. CT scan and three-di- mensional CT scans of thoracolumbar spine examinations showed replacement of spinal laminae began to merge;thoracal or lumbar physiological radian was good and no looseness or breakage was found in the mini-plates fixation system after 3 months. MRI examinations showed no neo- plasm recurrence or spinal cord compressed presented after 3 months. Conclusion Recapping laminoplasty with piezosurgery can provide precise anatomic reconstruction of the spinal canal with little risk. It＇s a new method to treat thoracolumbar intraspinal tumor.

关 键 词：胸腰椎椎管内肿瘤 超声骨刀 椎板回植 

分 类 号：R739.4[医药卫生—肿瘤]