带蒂棘突椎板韧带复合体回植在椎管内良性肿瘤切除术中的应用  

Clinical application of the modified replantation of pedicle spinous process and lamina complex in resection of benign tumors in the thoracic and lumbar spinal canal

作　　者：孙宜保[1] 祝孟坤[1] 常晓盼[1] 代耀军[1] 周晓光 杨勇[1] SUN Yibao;ZHU Mengkun;CHANG Xiaopan;DAI Yaojun;ZHOU Xiaoguang;YANG Yong(Zhengzhou Orthopedic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院,河南郑州450052

出　　处：《中国实用神经疾病杂志》2021年第7期585-589,共5页Chinese Journal of Practical Nervous Diseases

基　　金：郑州市科技局科研项目(编号:189PKJHM0780)。

摘　　要：目的探讨带蒂棘突椎板复合体回植在椎管内良性肿瘤切除术中的应用价值。方法郑州市骨科医院2018-09—2019-10治疗18例椎管内良性肿瘤患者,应用超声骨刀经骨切开病变节段及上、下椎体棘突椎板复合体,以一侧棘上韧带为蒂掀开棘突椎板复合体打开椎管,肿瘤切除后将带蒂棘突椎板复合体原位回植固定。术后观察患者的神经恢复情况,术后定期影像学复查了解截骨面对位及愈合情况。结果18例均获得随访,时间6~18个月,平均13.2个月,术后行X线、CT及MRI检查提示肿瘤无残留或原位复发,回植椎板位置良好,平均4.5个月回植椎板骨性愈合,未见继发医源性椎管狭窄、节段不稳相关并发症。结论采用超声骨刀切开、带蒂棘突椎板复合体回植治疗原发性椎管内肿瘤椎管,有助于重建脊柱的解剖结构,维护脊柱的稳定性,减少并发症,临床效果满意。Objective To explore the clinical value of modified replantation of pedicle spinous process and lamina complex in the treatment of benign tumor in spinal canal.Medthods From September 2018 to October 2019,18 patients with benign tumors in spi⁃nal canal were treated in this operation method.While one side supraspinal and interspinal ligaments were reserved as pedicles,the spinous process and lamina complex were removed by piezosurgery.After intraspinal tumors were resected,the spinous process and lamina complex with one side supraspinal and interspinal preserved as pedicle was replanted in situ.The patients were followed for neurologic recovery and imaging changes.Results The patients were followed up for 6 to 18 months(mean 13 months).There was no residual tumor or recurrence in situ according to postoperative X-rays,CT and MRI.All lamina replanted in situ kept in place during the followd-up period.It took 4.5 months(mean)for lamina of vertebra to acquire bone fusion.No vertibral instability or spinal stenosis was observed.Conclusion Modified replantation of pedicle spinous process and lamina complex during resection of benign spinal canal tumoris beneficial for reconstructing anantomical structure of spine,maintaining the postoperative spinal stability and decreasing complications.

关 键 词：椎管内肿瘤 超声骨刀 棘突椎板复合体 椎扳切除术 回植 

分 类 号：R739.9[医药卫生—肿瘤]