【摘要】 【目的】评价颈椎板棘突复合体截取原位回植椎管成形在颈椎管后部椎板切开入路手术中的应用价值。【方法】回顾性分析46例颈椎管内肿瘤患者临床资料,其中25例行椎板棘突复合体截取原位回植椎管成形,21例行椎板棘突咬除,根据脊髓损伤时日本骨科学会(JOA)评分标准评分,比较两组脊髓神经功能恢复程度及脊柱不稳、成角畸形发生率。【结果】术后3、6、12个月JOA评分增加幅度两组间差异有统计学意义(P<0.01);椎板棘突咬除组脊柱成角畸形或颈椎不稳发生率为23.81%、38.10%、61.90%,椎管棘突复位组脊柱成角畸形或颈椎不稳发生率为0%、4.00%、8.00%,两组间差异有统计学意义(P<0.01)。【结论】椎板棘突复合体截取原位回植椎管成形在颈椎管内肿瘤治疗中既恢复了椎管原生理解剖和次序,保证了颈椎的稳定,同时脊髓神经功能恢复良好,有效地防止了术后并发症的发生。更多还原

【Abstract】 【Objective】To evaluate the clinical application of replantation of lamina and spinous process complex in situ in the posterior cervical laminectomy surgery.【Methods】The clinical data of 46 cases of cervical tumor,of which 25 underwent replantation of lamina and spinous process complex in situ during laminoplasty and 21 underwent lamina and spinous process bite laminectomy,were analyzed retrospectively.According to spinal cord injury score standard by Japanese Orthopaedic Association(JOA),the functional recovery of the spinal cord,spinal instability and angular deformity rate were compared between two groups.【Results】 Three,six or twelve months after the treatment,the difference in the increase of JOA score between the two groups had statistical significance(P<0.01).The incidence of spinal angulation,spinal deformation or cervical instability in lamina and spinous process bite laminectomy group were 23.81%,38.10% and 61.90%,respectively,and those in the group of replantation laminoplasty of lamina and spinous process complex in situ were 0%,4.00% and 8.00%,respectively.The difference between two groups had statistical significance(P<0.01).【Conclusion】The cervical vertebra is the most active and vulnerable part of vertebral body.The replantation laminoplasty of lamina and spinous process complex in situ can restore the physiological anatomy and the order of vertibral canal,ensure the stability of cervical vertebra,recover spinal cord nerve function and be effective in the prevention of the occurrence of postoperative complications.更多还原