椎板回植微型钛板内固定在胸腰椎椎管内肿瘤切除术中的应用  

Application of lamina replantation and mini titanium-plate internal fixation in thoracolumbar spinal canal tumor resection

作　　者：伦智法 马超[1] 刘光旺[1] 胡孟子 冯杰[1] LUN Zhi-fa;MA Chao;LIU Guang-wang;HU Meng-zi;FENG Jie(Department of Spine Surgery,Xuzhou Central Hospital,Xuzhou,Jiangsu 221009,China)

机构地区：[1]徐州市中心医院脊柱外科,江苏221009

出　　处：《中国骨与关节损伤杂志》2022年第7期682-685,共4页Chinese Journal of Bone and Joint Injury

基　　金：江苏省科技项目(BE2016640);徐州市引进临床医学专家团队项目(2019TD002)。

摘　　要：目的评价椎板回植微型钛板内固定在胸腰椎椎管内肿瘤切除术中的应用效果。方法回顾性分析自2017-02—2019-12采用胸腰椎椎管内肿瘤切除术治疗的26例椎管内肿瘤,13例行椎板回植微型钛板内固定(椎板回植组),13例行椎板切除椎弓根钉内固定(椎板切除组)。比较两组手术时间、术中出血量、引流管拔除时间以及脑脊液漏、脊柱失稳、脊柱运动功能障碍、继发性椎管狭窄发生率,比较两组末次随访时的疼痛VAS评分、JOA评分。结果两组均顺利完成手术并获得完整随访,随访时间6~18个月,平均13个月。椎板回植组脑脊液漏、脊柱运动功能障碍、继发性椎管狭窄发生率较椎板切除组低,差异有统计学意义(P<0.05)。两组脊柱失稳发生率比较差异无统计学意义(P>0.05)。椎板回植组手术时间、术中出血量较椎板切除组少,引流管拔除时间较椎板切除组早,差异有统计学意义(P<0.05)。末次随访时两组疼痛VAS评分、JOA评分比较差异无统计学意义(P>0.05)。结论胸腰椎椎管内肿瘤切除术中应用椎板回植微型钛板内固定能有效重建椎管及脊柱后柱结构,降低脑脊液漏、脊柱运动功能障碍、继发性椎管狭窄发生率。Objective To evaluate the clinical effect of lamina replantation fixed by mini titanium-plate in thoracolumbar spinal canal tumor resection.Methods A retrospective analysis was performed on 26 cases of thoracolumbar spinal tumors treated by resection from February 2017 to December 2019,including 13 cases of lamina replantation and mini titanium-plate internal fixation(lamina replantation group)and 13 cases of laminectomy and pedicle screw fixation(laminectomy group).Operation time,intraoperative blood loss,drainage tube removal time,incidence of cerebrospinal fluid leak,spinal instability,spinal motor dysfunction,and secondary spinal stenosis were compared between the two groups,the pain VAS score and JOA score at the last follow-up were compared between the two groups.Results Both groups were successfully operated and followed up for 6 to 18months(mean 13 months).The incidence of cerebrospinal fluid leakage,spinal motor dysfunction and secondary spinal stenosis in the lamina replantation group were lower than those in the laminectomy group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of spinal instability between the two groups(P>0.05).The operation time and intraoperative blood loss in the lamina replantation group were less,and the drainage tube removal time was earlier than that in the laminectomy group,with statistical significance(P<0.05).There was no significant difference in pain VAS score and JOA score at the last follow-up between the two groups(P>0.05).Conclusion The application of lamina replantation fixed by mini titanium-plate in thoracolumbar spinal canal tumor resection can effectively reconstruct spinal canal and posterior column structure,and reduce the incidence of cerebrospinal fluid leakage,spinal motor dysfunction,and secondary spinal stenosis.

关 键 词：椎管内肿瘤 椎板回植 微型钛板 内固定 

分 类 号：R687.3[医药卫生—骨科学]