Goel A
Department of Neurosurgery, King Edward Memorial Hospital, Bombay, India.
Surg Neurol. 1997 Nov;48(5):442-5. doi: 10.1016/s0090-3019(97)00292-9.
Various advantages of a laminoplasty over the conventional laminectomy have been listed in the recent literature. An alternative method of vascularized pedicled laminoplasty is described in this report.
A linear cut is made in the laminae in their lateral aspects and two or more laminae are elevated as a flap and pedicled on supraspinous, interspinous, and interlaminar ligaments. The procedure was performed in 10 cases where surgery was performed for spinal intradural pathology. The ages of these patients ranged from 21 to 60 years.
In an average observation period of 8 months, no demonstrable resorption of the laminar flap was observed in any case. None of the patients complained of any additional discomfort, pain, or deformity that could be related to the laminoplasty.
Laminoplasty using laminae with a vascularized pedicle as described may be better tolerated by the patient; the segment seems to be more resistant to infection and radiotherapy. It is a simple, safe, and stable alternative to the procedures of laminoplasty previously described. No sophisticated instrumentation, prosthetic material, or technically complex maneuvers are required to harvest and reposition the laminar flap.
近期文献中列举了椎板成形术相对于传统椎板切除术的各种优势。本报告描述了一种带血管蒂椎板成形术的替代方法。
在椎板的外侧做一条直线切口，将两个或更多椎板掀起形成一个皮瓣，并以棘上韧带、棘间韧带和椎板间韧带为蒂。该手术在10例因脊髓硬膜内病变而进行手术的患者中实施。这些患者的年龄在21岁至60岁之间。
在平均8个月的观察期内，未观察到任何一例椎板皮瓣有明显吸收。没有患者抱怨与椎板成形术相关的任何额外不适、疼痛或畸形。
如所述使用带血管蒂椎板进行椎板成形术可能更易被患者耐受；该节段似乎对感染和放疗更具抵抗力。它是先前描述的椎板成形术的一种简单、安全且稳定的替代方法。采集和重新放置椎板皮瓣无需复杂的器械、假体材料或技术复杂的操作。
