| 带蒂椎板内板切除原位回植术治疗椎管狭窄症 |
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Received:May 10, 2004
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| 期刊信息：《中国骨伤》2004年17卷，第10期，第577-579页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目:广东省医学科研基金资助项目(A2001753) |
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目的:探讨一种治疗腰椎管狭窄症的方法,使术后脊柱解剖结构及椎管形态较接近生理状态。
方法:设计带蒂椎板内板切除后原位回植的方法治疗椎管狭窄症94例。分析患者手术前后椎板厚度、椎管截面积、临床疗效。
结果:术后椎板厚度L3、L4、L5分别减少至(4.89±1.10)mm、(4.78±0.96)mm、(5.10±0.91)mm,平均厚度(4.91±0.95)mm。椎管截面积L3、L4、L5下缘层面分别扩大至(148.66±12.82)mm2、(196.46±24.93)mm2、(196.98±23.09)mm2,平均截面积(193.66±26.27)mm2。各项指标与术前比较差异有非常显著性意义(P<0.001)。术后随访5-8年,按疗效评定标准:优73例,良16例,差5例。
结论:腰椎管狭窄症的致窄因素除了关节突内聚肥大、黄韧带增厚之外,椎板肥硕增厚也是重要的原因,治疗方式应针对这些病理改变而设计。治疗应扩大椎管容积,在此基础上应尽量减少解剖结构的切除,使术后脊柱的稳定性较好;还应恢复椎管截面类圆形的生理形态,使适合脊髓神经根容纳,利于神经功能恢复。 |
| [关键词]:椎管狭窄症 外科手术 稳定性 功能恢复 |
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| Treatment of spinal canal stenosis with the spine canaloplasty that the pedunculated laminotomy and the lamina arcus vertebrae was regrafted to the sectioned former location |
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Abstract:
Objective:To explore a new method for treatment of spinal canal stenosis, in order to recover spinal anatomic structure and form of spinal canal near physiological state after operation.
Methods: Plan a laminoplasty that the inner plate of lamina arcue vertebrae with vascularized pedicle was reseted and the lamina arcus vertebrae was regrafted to the sectioned former location to treat spinal canal stenosis. Ninty-four patients of spinal canal stenosis were treated, their thickness of lamina of vertebra,across section area of spinal canal and clinical effect were analyzed in the preoperative and postoperative periods.
Results:The thickness of postoperative lamina of vertebra in L3, L4 and L5 reduced to (4.89± 1.10) mm, (4.78±0.96) mm and (5.10±0.91) mm respectively, the average thickness was (4.91±0.95) mm. The across sectional area of spinal canal in L3,L4 and L5 expanded to (148.66±12.82) mm2, (196.46±24.93) mm2 and (196.98 ± 23.09) mm2 respectively,the average across sectional area was (193.66± 26.27) mm. There were significant differences was observed between preoperation and postoperation (P < 0.001 ). All cases were followed up from 5 to 8 years,according to standard of evaluation,73 patients got excellent result, 16 patients got good result,and 5 patients fair.
Conclusion:The another important reason of spinal canal stenosis is that the thickness of lamina arcus vertebrae became thicker and fatter,besides processus articularis become larger and arcuate ligaments become thicker. The plan of orthopaedic procedures shoud be in view of these situation with pathoanatomical change,enlarged the volume of the spinal canal,and rarely reset the physio-anatomical structure of spine. The stability to spine should be maintained better and the physio-anatomical structure of the cross-section area of spinal canal should be restore. It is appropriate for the capacity of spinal nerves root in the spinal canal,and is benefit to recove nerves funtion. |
| KEYWORDS:Spinal canal stenosis Surgery, operation Stability Recovery of function |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李文基,潘维文,覃辉.带蒂椎板内板切除原位回植术治疗椎管狭窄症[J].中国骨伤,2004,17(10):577~579 |
| 英文格式: | LI Wen-ji,PAN Wei-wen,QINHui.Treatment of spinal canal stenosis with the spine canaloplasty that the pedunculated laminotomy and the lamina arcus vertebrae was regrafted to the sectioned former location[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(10):577~579 |
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