CAJ | 학술논문

目的：探讨带蒂椎板复合体回植、钛网固定行椎管成形术治疗退行性腰椎管狭窄症的临床疗效。方法根据临床表现和影像学检查确定减压部位，对15例退行性腰椎管狭窄患者保留双侧关节突关节，采用磨钻或微型咬骨钳沿双侧关节突内侧缘打开一个或多个椎板，切断一端棘上和棘间韧带，将椎板复合体翻转，椎管减压后再将其原住回植，钛网固定，重建椎管完整性和脊柱的稳定性。应用VAS 和ODI 评分对手术前后临床疗效进行主客观评价。结果随访12~28个月，平均(13±0．5)个月，所有病例回植物稳定，无塌陷及椎管狭窄，术后患者VAS 和ODI 评分较术提高，差异有统计学意义(P <0．05)。结论退行性腰椎管狭窄症术中将带蒂椎板复合体翻转，术后用钛网回植固定，方法简便、安全，不限制脊柱活动度，减少术后脊柱不稳及加速退变等并发症。
목적：탐토대체추판복합체회식、태망고정행추관성형술치료퇴행성요추관협착증적림상료효。방법근거림상표현화영상학검사학정감압부위，대15례퇴행성요추관협착환자보류쌍측관절돌관절，채용마찬혹미형교골겸연쌍측관절돌내측연타개일개혹다개추판，절단일단극상화극간인대，장추판복합체번전，추관감압후재장기원주회식，태망고정，중건추관완정성화척주적은정성。응용VAS 화ODI 평분대수술전후림상료효진행주객관평개。결과수방12~28개월，평균(13±0．5)개월，소유병례회식물은정，무탑함급추관협착，술후환자VAS 화ODI 평분교술제고，차이유통계학의의(P <0．05)。결론퇴행성요추관협착증술중장대체추판복합체번전，술후용태망회식고정，방법간편、안전，불한제척주활동도，감소술후척주불은급가속퇴변등병발증。
Objective To investigate the therapeutic effects of laminoplasty of pedicled complex replantation on recon-struction of spinal canal at lumbar spinal stenosis. Methods The involved segments were determinged by symptoms, clinical fea-tures and radiographic at the initial examination. 15patients with lumbar spinal stenosis were treated in our hospital. Each case was reserved bilateral facet joint,one or several vertebral lamina were cut by burr drill or micro-rongeur along the inner edge of bilateral facet joint,Superspinal and interspinal ligaments of one side were cut,then pedicelar vertehral lamina complex was retroflexed and intraspinal canal was exposured. After Lumbar spinal canal decompression,pedicelar vertebral lamina complex was replanted and ti-tanic mesh was fixated to reconstruct the integrity of vertebral canal and the stability of spinal column. Application VAS and ODI scoring method for subjective and objective evaluation of clinical curative effect before and after operation. Results The patients were followed up for 12 to 28 months[(13 ± 0. 5) months on average],during which no collapse of the replanted tissues or spinal canal stenosis occurred. Postoperative patients VAS and ODI score significantly higher than before,the difference was statistically sig-nificant(P<0. 05). Conclusion Retroflexing pedicelar vertebral plate complex and fixating with titanium plate in the lumbar spi-nal stenosis is simple,safe. The spinal column active naturelv without limit postoperatively,the technique can maintain the spinal col-umn good stability and protect the spinal column from degradation.