双开门纳米人工骨椎管成形术在颈椎管内肿瘤切除中的应用  

Double Door Laminoplasty Combined with Artificial Nano Bone in the Treatment of Tumor in Cervical Vertebral Channel

作　　者：钟艳春[1] 刘午阳[1] 刘禄林[1] 肖建华[1] 叶勇军[1] 何春耒[1] 黄为民[1] 吴东保[1] ZHONG Yan-chun;LIU Wu-yang;LIU Lu-lin;XIAO Jian-hua;YE Yong-jun;HE Chun-lei;HUANG Wei-min;WU Dong-bao(Dept. of Orthopedic surgery, the First Affiliated Hospital of Gannan Medical University, Ganzhou, jiangxi 341000)

机构地区：[1]赣南医学院第一附属医院黄金院区骨科,江西赣州341000

出　　处：《赣南医学院学报》2018年第4期337-340,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省科技厅计划项目(20122BBG70108);江西省卫生和计划生育委员会计划项目(20155417)

摘　　要：目的:观察双开门纳米人工骨块椎管成形术切除颈椎管内肿瘤的疗效。方法:分析我院2010年5月至2015年6月采用双开门纳米人工骨块椎管扩大成形术切除颈椎管内肿瘤的24例患者,手术前后采用JOA评分,评估脊髓功能恢复情况,摄X线片观察颈椎活动度变化,统计术后并发症发生情况。结果:24例患者术中显露均满意,22例髓外肿瘤完整切除,2例髓内肿瘤部分切除,术后2例出现脑脊液漏,经保守治疗后愈合。平均随访时间13.4个月(9~36个月),所有患者随访期间神经及脊髓功能均有明显恢复,术前JOA评分(8.5±1.22)分,末次随访时平均JOA评分上升至(13.12±1.37)分(P<0.001);颈椎活动度、稳定性良好,手术节段椎体未见滑脱失稳,2例出现轴性症状(发生率8.3%),均未出现C5神经根麻痹症状。结论:应用双开门纳米人工骨椎管成形术治疗颈椎管内肿瘤是一种安全有效的方法,不仅瘤体显露充分,还能较好保持颈椎稳定性,灵活性。Objective： To evaluate the efficacy of double door laminoplasty combined with artificial nano bone on tumors in cervical vertebral channel. Methods： Twenty-four patients with tumors in cervical vertebral channel treated with double door laminoplasty combined with artificial nano bone in the Department of Orthopedics from May 2010 to June 2015 were enrolled in the study. The recovery of spinal cord function was evaluated by JOA score before and after operation.The chang of cervical vertebra motion were measured by x-ray photograph. The incidence of postoperative complications was counted. Results： The intraoperative exposure in 24 patients were all satisfactory. Extramedullary tumors in 22 cases were completely resected and the intramedullary tumors in 2 cases were partially resected. Cerebrospinal fluid leakage occurred in 2 cases after operation and healed by conservative treatment. All patients were followed up for 9 to 36 months with an average of 13. 4 months. The neurological and spinal cord function of all the patients recovered significantly during the follow-up period. The preoperative JOA score was 8. 5 ± 1. 22,and the average JOA score increased to 13. 12 ±1. 37 at the last follow-up（ P〈0. 001）. The activity and stability of cervical vertebrae were kept good. No spondylolisthesis and instability phenomena were observed in all the patients. Two patients had axial symptom and no patients had C5 nerve root palsy after surgery. Conclusions： To treat tumor in the cervical vertebral channel with double door laminoplasty combined with artificial nano bone is safe and effective. It can not only expose the tumor to the full degre,but also maintain the stability and flexibility of cervical spine.

关 键 词：双开门椎管成形术 人工纳米骨块 颈椎管 肿瘤 

分 类 号：R687.3[医药卫生—骨科学]