长节段椎板-棘突复合体回植进行椎管重建在长节段椎管内肿瘤手术中的应用  

Clinical efficacy of spinal canal reconstruction by replantation of long-segment spinous process-lamina complex after resection of long-segment intraspinal tumors

作　　者：王年华[1] 袁辉纯[1] 何俊 曹武阳 袁敏[1] 杨增 杨少波 周志伟 徐立新[1] 冷海斌[1] WANG Nian-hua;YUAN Hui-chun;HE Jun;CAO Wu-yang;YUAN Min;YANG Shao-bo;ZHOU Zhi-wei;XU Li-xin;LENG Hai bin(Department of Neurosurgery,The First People's Hospital of Changde City,Changde 415003,China)

机构地区：[1]常德市第一人民医院神经外科,湖南415003

出　　处：《中国临床神经外科杂志》2023年第7期437-439,443,共4页Chinese Journal of Clinical Neurosurgery

基　　金：湖南省神经外科学临床医疗技术示范基地(2018SK4003)。

摘　　要：目的 探讨长节段(≥4个节段)椎板-棘突复合体回植进行椎管重建在长节段椎管内肿瘤手术中的应用效果。方法回顾性分析2014年1月至2020年12月显微手术治疗的6例长节段椎管内肿瘤的临床资料。术中采取长节段椎板-棘突复合体回植复位+钛板钛钉固定的方法进行椎管重建。结果 肿瘤位于颈胸段3例,胸腰段1例,腰段1例,腰骶段1例。肿瘤全切除5例,大部分切除1例。术后病理检查显示室管膜瘤3例,神经鞘瘤1例,脂肪瘤1例,畸胎瘤1例。术后随访2~7年,未见肿瘤复发,未见椎管狭窄,未见脊柱不稳及滑脱,部分椎板已骨性愈合。结论 对长节段椎管内肿瘤,采用长节段椎板-棘突复合体回植方法进行椎管重建,手术疗效肯定,术后并发症少,脊柱稳定性影响小。Objective To investigate the clinical efficacy of spinal canal reconstruction by replantation of long-segment(more than four segments)spinous process-lamina complex after the resection of long-segment intraspinal tumors.Methods The clinical data of 6 patients with long-segment spinal tumors who underwent spinal canal reconstruction by replantation of long-segment spinous process-lamina complex after the resection of intraspinal tumors from January 2014 to december 2020 were retrospectively analyzed.Results The tumors were located in the cervicothoracic segment in 3 patients,thoracolumbar segment in 1,lumbar segment in 1,and lumbosacral segment in 1.Total resection of the tumors was achieved in 5 patients and great partial in 1.Postoperative pathological results showed ependymoma in 3 patients,schwannoma in 1,lipoma in 1 and teratoma in 1.The follow-up(2~7 years)showed no tumor recurrence,spinal stenosis,spinal instability or spondylolisthesis.Conclusions For long-segment intraspinal tumors,it is an effective method to the spinal canal reconstruction by replantation of long-segment spinous process-lamina complexwith,which has advantages such as few postoperative complications and little influence on spinal stability.

关 键 词：椎管内肿瘤 显微手术 椎板-棘突复合体 椎管重建术 脊柱稳定性 

分 类 号：R739.42[医药卫生—肿瘤] R651.11[医药卫生—临床医学]