棘突椎板复合体回植联合螺钉固定在胸椎椎管内肿瘤切除术中的应用效果  

Application effect of spinous lamina complex replantation combined with screw internal fixation in thoracic intravertebral tumor resection

作　　者：何震宇 张功恒 张亮 甘心荣 汪逃芳 唐本雨 HE Zhenyu;ZHANG Gongheng;ZHANG Liang;GAN Xinrong;WANG Taofang;TANG Benyu(Department of Spine Surgery,Yichun People's Hospital,Jiangxi Province,Yichun366000,China;Department of Orthopedics,Wanzai Lounty People's Hospital,Jiangxi Province,Wanzai366100,China)

机构地区：[1]江西省宜春市人民医院脊柱外科,江西宜春366000 [2]江西省万载县人民医院骨科,江西万载366100

出　　处：《中国当代医药》2023年第32期65-68,72,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212675)。

摘　　要：目的探究棘突椎板复合体回植联合螺钉固定在胸椎椎管内肿瘤切除术中应用效果。方法回顾性选取2019年3月至2022年8月于宜春市人民医院行胸椎椎管内肿瘤切除术45例患者作为研究对象,根据手术方法不同分为三组,各15例。A组采用传统全椎板切除复合椎弓根螺钉内固定术治疗,B组采用全椎板切除棘突椎板复合体回植钛板内固定术,C组采用全椎板切除棘突椎板复合体回植联合螺钉内固定术。比较三组围手术期指标、日本骨科协会(JOA)评分及JOA改善率、术后脊柱活动度。结果三组手术时间及术中出血量比较,差异有统计学意义(P<0.05),术后骨性愈合时间三组比较,差异无统计学意义(P>0.05);C组手术时间、术后骨性愈合时间均短于A组及B组,术中出血量少于A组及B组,差异有统计学意义(P<0.05)。三组术前JOA评分比较,差异无统计学意义(P>0.05);术后三组JOA评分比较,差异有统计学意义(P<0.05);三组术前JOA评分比较,差异无统计学意义(P>0.05);术后C组JOA评分均高于A组及B组,差异有统计学意义(P<0.05)。三组术后脊柱活动度比较,差异有统计学意义(P<0.05);C组腰椎冠状面侧屈、矢状面屈伸,胸椎冠状面侧屈、水平面旋转度均高于A组及B组,差异有统计学意义(P<0.05)。结论棘突椎板复合体回植联合螺钉固定在胸椎椎管内肿瘤切除术应用中可获得较好的手术效果,手术对患者造成创伤较小,利于促进患者胸腰椎功能的恢复,且不影响术后脊柱活动度,对促进术后恢复具有重要作用。Objective To explore the effect of spinous process lamina complex replantation combined with screw internal fixation in thoracic intravertebral tumor resection.Methods Retrospective analysis was performed on 45 patients who underwent thoracic intraspinal tumor resection in Yichun People's Hospital from March 2019 to August 2022.They were divided into three groups according to different surgical methods,with 15 cases in each group.Group A was treated with traditional total laminectomy combined with pedicle screw internal fixation,group B was treated with total laminectomy spinous process and lamina complex replantation with titanium plate internal fixation,and group C was treated with total laminectomy spinous process and lamina complex replantation with screw internal fixation.Perioperative indexes,Japanese Orthopaedic Association(JOA)score,JOA improvement rate and postoperative spinal range were compared among the three groups.Results There were significant differences in operation time and blood loss among the three groups(P<0.05),but no significant difference in bone healing time among the three groups(P>0.05).The operation time and postoperative bone healing time in group C were shorter than those in group A and group B,and the intraoperative blood loss was lower than that in group A and group B,showing significant differences(P<0.05).There was no significant difference in preoperative JOA score between the three groups(P>0.05).There were significant differences in JOA scores among the three groups after operation(P<0.05).There was no significant difference in preoperative JOA score between the three groups(P>0.05).The postoperative JOA score of group C was higher than that of group A and group B,and the differences were statistically significant(P<0.05).There was statistically significant difference in postoperative spinal mobility between the three groups(P<0.05).The lumbar coronal lateral flexion and sagittal flexion and extension in group C were higher than those in group A and group B(P<0.05).The thoraci

关 键 词：胸椎椎管内肿瘤 棘突椎板复合体回植 螺钉固定 腰椎功能评分 

分 类 号：R61[医药卫生—外科学]