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颈椎椎板成形术:使用新型钛板维持椎管扩大——手术技术

Cervical laminoplasty: use of a novel titanium plate to maintain canal expansion--surgical technique.

作者信息

Park Andrew E, Heller John G

机构信息

Emory Spine Center, Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA, USA.

出版信息

J Spinal Disord Tech. 2004 Aug;17(4):265-71. doi: 10.1097/01.bsd.0000095401.27687.c0.

Abstract

Cervical laminoplasty is a technique used to achieve spinal cord decompression in cases of myelopathy or myeloradiculopathy. The most common reason for failure of this technique is restenosis due to hinge closure. Various techniques have been employed to hold the laminar "door" open while the body heals the lamina hinge in the new expanded position. Ideally, a method of achieving laminar fixation should be technically straightforward, provide secure laminar fixation, and be rapid to minimize the risk of iatrogenic injuries, blood loss, and operative time. The authors describe the use of a novel plate designed to accomplish these goals. The technical issues relevant to performing the laminoplasty and securing the laminae are discussed. The plate has been proven biomechanically to be equal or superior to the currently used techniques. The use of this plate will allow the patient to engage in an early active rehabilitation protocol-while minimizing the risk of restenosis of the canal. This may ultimately lead to better preservation of motion and decreased axial neck pain following laminoplasty.

摘要

颈椎板成形术是一种用于在脊髓病或脊髓神经根病病例中实现脊髓减压的技术。该技术失败的最常见原因是由于铰链闭合导致的再狭窄。在身体将椎板铰链愈合到新的扩张位置时,已经采用了各种技术来保持椎板“门”打开。理想情况下,一种实现椎板固定的方法在技术上应该简单直接,提供可靠的椎板固定,并且快速以尽量减少医源性损伤、失血和手术时间的风险。作者描述了一种旨在实现这些目标的新型钢板的使用。讨论了与进行椎板成形术和固定椎板相关的技术问题。该钢板已在生物力学上被证明与目前使用的技术相当或更优越。使用这种钢板将使患者能够参与早期积极的康复方案,同时将椎管再狭窄的风险降至最低。这最终可能导致更好地保留活动度并减少颈椎板成形术后的轴向颈部疼痛。

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