棘突椎板韧带复合体重建在胸腰椎椎管内肿瘤切除术中的应用  

Application of spinous process and lamina ligament complex reconstruction in resection of thoracolumbar intraspinal tumors

作　　者：何震宇 张功恒 张亮 甘心荣 汪逃芳 唐本雨 HE Zhen-yu;ZHANG Gong-heng;ZHANG Liang;GAN Xin-rong;WANG Tao-fang;TANG Ben-yu(Dept of Spine Surgery,the People′s Hospital of Yichun City,Yichun,Jiangxi 336000,China)

机构地区：[1]宜春市人民医院脊柱外科,江西宜春336000

出　　处：《临床骨科杂志》2025年第1期1-5,共5页Journal of Clinical Orthopaedics

基　　金：江西省卫健委科技计划项目(编号:202212675)。

摘　　要：目的探讨棘突椎板韧带复合体重建在胸腰椎椎管内肿瘤切除术中的应用效果。方法采用椎管内肿瘤切除术治疗40例胸腰椎椎管内肿瘤患者,并根据术中处理方法不同将患者分为观察组(行棘突椎板韧带复合体重建治疗,20例)与对照组(行全椎板切除术治疗,20例)。比较两组手术情况、疼痛VAS评分、JOA评分、ODI评分、并发症发生率,记录观察组患者复合体回植重建后骨愈合率。结果患者均获得随访,时间12~24个月。手术时间、术中出血量、术后引流量观察组均短(少)于对照组(P<0.01)。两组术后1周疼痛VAS评分、术后1年JOA评分及ODI评分均较术前改善(P<0.05);术后1周疼痛VAS评分两组比较差异无统计学意义(P>0.05),术后1年JOA评分、ODI评分观察组均优于对照组(P<0.01)。两组并发症发生率比较差异无统计学意义(P>0.05)。观察组末次随访时19例患者复合体回植重建后完全愈合。结论椎管内肿瘤切除术中采用棘突椎板韧带复合体重建,有利于胸腰椎椎管内肿瘤患者腰椎功能的恢复,且创伤更小。Objective To investigate the application effect of spinous process and lamina ligament complex reconstruction in resection of thoracolumbar intraspinal tumors.Methods Forty patients with thoracolumbar intraspinal tumors were treated with intraspinal tumor resection,and the patients were divided into two groups according to the different intraoperative treatment methods:The observation group(20 patients were performed with spinous process and lamina ligament complex reconstruction)and the control group(20 patients were treated with total laminectomy).The surgical situations,pain VAS,JOA score,ODI score,and complication incidence were compared between the two groups,and the bone healing rate after the complex replanting reconstruction in the observation group was recorded.Results All patients were followed up for 12~24 months.The operation time,intraoperative bleeding volume,and postoperative drainage volume in the observation group were all shorter(less)than those in the control group(P<0.01).The pain VAS at postoperative 1 week,JOA score of 1 year postoperation and ODI score of both groups were all improved than those before operation(P<0.05).There was no statistical difference in the pain VAS between the two groups at 1 week after operation(P>0.05),and at 1 year after operation,JOA score and ODI score of the observation group were better than those of the control group(P<0.01).There was no statistical difference in the incidence of complications between the two groups(P>0.05).At the final follow-up,19 patients in the observation group had complete bone healing after complex replanting reconstruction.Conclusions During resection of thoracolumbar intraspinal tumors,using lamina ligament complex reconstruction is beneficial to the recovery of lumbar function,with less trauma.

关 键 词：胸腰椎 椎管内肿瘤 棘突椎板韧带复合体重建 螺钉固定 腰椎功能 

分 类 号：R738.1[医药卫生—肿瘤] R687.2[医药卫生—临床医学] R687.3