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目的探讨在成人椎管内肿瘤切除术中棘突椎板切开复位术式特点、应用效果及术后椎管稳定性价值。方法经后正中入路行椎管内肿瘤切除18例,术中分开椎旁肌,将相应病变节段包括棘突椎板整体切割取下。切除肿瘤后,将取下的棘突椎板整体原位回植,钛片-钛钉固定。结果18例病人肿瘤全切17例,全切率94.4%。所有病例术野显露满意,脊髓或神经根损伤均未加重,术后7~10 d摄X线片观察,棘突椎板恢复原位连续性,无1例移位。随访1~3年,复查MRI、X线片,回植的组织均无移位,全部骨性愈合。结论该术式能够显露充分,重建椎管结构,保持脊柱稳定性,减少术后并发症的发生。
Objective To investigate the surgical procedure, the application effect and the stability of postoperative spinal canal in the surgical resection of spinal canal in adult spinal canal. Methods Twenty-eight cases underwent resection of intraspinal canal tumor via median approach. The paravertebral muscles were separated and the corresponding lesion segments, including the spinous process, were removed. After resection of the tumor, the entire spinous process of vertebral plate removed will be replanted in situ, and the titanium plate is fixed with titanium nail. Results Totally 17 cases were resected in 18 cases and the rate of resection was 94.4%. In all cases, the surgical field was satisfactorily satisfied, and the spinal cord or nerve root injury was not aggravated. X-ray films were taken at 7-10 days after operation and the lamina of spinous process were restored to original continuity without any one shift. Follow-up 1 to 3 years, review MRI, X-ray films, the organization did not shift back all the bone healing. Conclusion The procedure can reveal the full, reconstruction of spinal canal structure, maintain the stability of the spine and reduce the incidence of postoperative complications.