Hida Shinichi, Naito Masatoshi, Arimizu Jun, Morishita Yuichiro, Nakamura Atsuhiko
Department of Orthopaedic Surgery, School of Medicine, Fukuoka University, 7-45-1 Nanakuma Jonanku, 814-0180, Fukuoka, Japan.
Eur Spine J. 2006 Aug;15(8):1292-7. doi: 10.1007/s00586-006-0099-7. Epub 2006 Apr 13.
Laminoplasty for thoracic and lumbar spine surgery enables surgeons to preserve the posterior arch of the spine while preventing invasion of hematoma and scar tissue, postoperative instability, subluxation, and kyphotic deformities. The authors have developed a new surgical technique: namely, transverse placement laminoplasty (TPL) using titanium miniplates. Eight patients and 18 laminae underwent TPL using a titanium mini-plate. The preoperative diagnoses were six intradural tumors, one ossification of a yellow ligament and one spontaneous spinal cord herniation. The mean blood loss was 219 g and the mean duration of surgery was 3 h and 54 min. The mean postoperative follow-up period was 2 years and 1 month. All eight patients started to sit with a soft brace within the second postoperative day, and were able to walk within the fifth postoperative day. There were no cases of spinal deformity, an invasion of hematoma or scar tissue into the spinal canal on magnetic resonance imaging, or back pain. TPL simultaneously enables surgeons to obtain sufficient field of vision and rigid early fixation of the reduced lamina at the time of surgery. Moreover, our novel technique also simplifies the postoperative treatment, while preserving the posterior arch of the spine, and also preventing an invasion of a hematoma and scar tissue, postoperative instability, subluxation, and kyphotic deformities.
胸腰椎手术的椎板成形术使外科医生能够保留脊柱后弓,同时防止血肿和瘢痕组织侵入、术后不稳定、半脱位和后凸畸形。作者开发了一种新的手术技术:即使用钛微型钢板的横向放置椎板成形术(TPL)。八名患者的18个椎板接受了使用钛微型钢板的TPL手术。术前诊断为6例硬脊膜内肿瘤、1例黄韧带骨化和1例自发性脊髓疝。平均失血量为219克,平均手术时间为3小时54分钟。术后平均随访期为2年1个月。所有8例患者在术后第二天内开始佩戴软支具坐立,并在术后第五天内能够行走。没有出现脊柱畸形、磁共振成像显示血肿或瘢痕组织侵入椎管或背痛的病例。TPL使外科医生在手术时能够同时获得足够的视野并对复位的椎板进行早期牢固固定。此外,我们的新技术还简化了术后治疗,同时保留了脊柱后弓,还防止了血肿和瘢痕组织的侵入、术后不稳定、半脱位和后凸畸形。