PLC回植椎管成形术与全椎板切除联合椎弓根钉内固定术治疗原发性椎管内肿瘤的疗效  

Efficacy of posterior ligamentous complex regrafting surgery and laminectomy with pedicle screw internal fixation in treatment of primary tumor of thoracolumbar spinal canal

作　　者：吴雨璇 阴鲁鑫 华磊 蒋健 孟柏屹 冯骁 袁泉 WU Yuxuan;YIN Luxin;HUA Lei(Department of Neurosurgery,Affiliated Hospital,Xuzhou Medical University,Xuzhou 221000,CHINA)

机构地区：[1]徐州医科大学附属医院神经外科,江苏221000 [2]徐州医科大学附属医院骨科,江苏221000

出　　处：《江苏医药》2021年第3期268-273,共6页Jiangsu Medical Journal

摘　　要：目的观察后方韧带复合体(PLC)回植椎管成形术与全椎板切除联合椎弓根钉内固定术治疗原发性椎管内肿瘤的临床疗效。方法回顾性分析45例胸、腰椎椎管内原发性肿瘤患者的临床资料。其中,采用PLC回植椎管成形术25例(A组),全椎板切除联合椎弓根钉内固定术20例(B组)。比较两组相关资料。结果与B组比较,A组术中出血量少[(205.7±55.1) mL vs.(506.6±187.8) mL],术后引流量少[(136.0±31.6) mL vs.(211.0±26.5) mL](P<0.05)。两组术后7 d和末次随访时的VAS疼痛评分、日本骨科协会(JOA)评分及Oswestry功能障碍指数(ODI)评分均较术前改善(P<0.05)。末次随访时,A组ODI评分低于B组[(20.2±2.4)分vs.(22.9±2.9)分](P<0.05)。A组发生脑脊液漏3例;B组发生脑脊液漏5例,其中合并感染3例。结论PLC回植椎管成形术治疗胸、腰椎椎管内原发性肿瘤具有良好的临床疗效;与全椎板切除联合椎弓根钉内固定术比较,有利于远期腰椎功能的恢复。Objective To observe the clinical efficacy of posterior ligamentous complex(PLC) regrafting surgery and laminectomy with pedicle screw internal fixation in the treatment of primary tumor of the thoracolumbar spinal canal.Methods Clinical data of 45 patients with primary tumor of the thoracolumbar spinal canal were retrospectively analyzed, who were treated with PLC regrafting surgery(group A,25 cases) or laminectomy with pedicle screw internal fixation(group B,20 cases).The relevant indicators were compared between the two groups.Results Compared to group B,group A had less intraoperative blood loss [(205.7±55.1) mL vs.(506.6±187.8) mL] and postoperative drainage [(136.0±31.6) mL vs.(211.0±26.5) mL](P<0.05).Compared to before, the VAS pain scores, JOA scores and Oswestry disability index questionnaire(ODI) scores on the 7th day after operation and at the final follow-up were significantly improved in both groups(P<0.05).The ODI score at the final follow-up was less in group A than that in group B [(20.2±2.4) points vs.(22.9±2.9) points](P<0.05).Cerebrospinal fluid leakage occurred in 3 cases of group A.There were 5 cases with cerebrospinal fluid leakage after operation in group B,of whom 3 cases were with co-infection.Conclusion The PLC regrafting surgery has a good clinical efficacy in the treatment of primary tumor of the thoracolumbar spinal canal.Compared with laminectomy combined with pedicle screw internal fixation, PLC regrafting surgery is beneficial to the recovery of long-term lumbar function.

关 键 词：椎管内肿瘤 椎板切除术 后方韧带复合体 内固定术 

分 类 号：R739[医药卫生—肿瘤]