椎管内肿瘤切除术中椎管解剖重建
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作者单位:

1.遵义医科大学附属医院;2.遵义医科大学第二附属医院

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中图分类号:

R739.42

基金项目:

遵义医学院硕士启动基金(F-923);贵州省科技厅科技支撑计划(黔科合支撑 [2019]2812号)


Spinal canal anatomical reconstruction technique in intraspinal tumor resection
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Affiliation:

1.the Affilliated Hospital of Zunyi Medical University;2.the Second Affilliated Hospital of Zunyi Medical University

Fund Project:

the Master’s Science Research Startup Funding of Zunyi Medical University (grant number F-923); Science and Technology Support Plan of Guizhou Science and Technology Department (grant number [2019] 2812)

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    摘要:

    目的 探讨椎管内肿瘤切除术中椎管重建技术的特点和效果。方法 2013.02至2017.05,48例患者接受肿瘤摘除后用center piece钛板重建椎管,男28例,女20例。年龄21~56岁,平均35.92±10.63岁。病程1~8月,平均4.08±2.28月。肿瘤位于胸段16例,腰段20例,胸腰段12例。ODI和Frankel分级分别评估患者生活质量和神经功能。结果 2例患者术后出现脑脊液漏,经相应处理后治愈。无其他并发症。48例均获随访,时间24~66月,平均35.83±13.62月。末次随访时,平均ODI为4.08±2.15,较术前明显降低(t=6.442,P<0.05);Frankel分级均有1~2级提高,改善明显(P<0.05);脊柱活动度较术前明显升高(t=8.375,P <0.05),平片未见脊柱后凸、侧弯或不稳;CT见回植椎板愈合良好,椎管容积良好;无肿瘤复发。结论 椎管内肿瘤切除术中用center piece钛板重建椎管可保持椎管容积,维持脊柱骨-韧带结构完整,保护脊柱生理功能,是一种有效的治疗椎管内肿瘤的“功能性手术”。

    Abstract:

    Objective To explore the features and clinical effects of spinal canal anatomical reconstruction in intraspinal tumor resection. Methods From Feb. 2013 to May. 2017, tumor resection and anatomical reconstruction of spinal canal with center piece titanium plates were conducted for 48 patients. There were 28 males and 20 females. The age ranged from 21 to 56 years, with an average of 35.92±10.63 years old. The disease duration was 1-8 months with an average of 4.08±2.28 months. Tumors located in the thoracic, lumbar, and thoracolumbar region were 16, 20, and 12 cases, respectively. The ODI and Frankel classification were used to assess the quality of life and neurological function. Results Two patients had cerebrospinal fluid leakage after operation, which was cured after corresponding treatment. No other surgical complications were recorded. The 48 patients were followed up for 24-66 months with an average of 35.83±13.62 months. At final follow-up stage, the average ODI was 4.08±2.15, which was significant compared with preoperative ODI (t=6.442,P<0.05); Frankel grade was improved significantly when compared with preoperative grade (P<0.05); According to plain radiographs, The range of motion was increased significantly (t=8.375,P <0.05), no kyphosis, scoliosis, or instability was observed; CT showed the posterior spinal canal was well reconstructed; No tumor recurrence was observed. Conclusion Reconstruction of the spinal canal with center piece titanium plate in intraspinal tumors resection can maintain the volume of spinal canal, maintain the integrity of spinal bone-ligament structure, and protect the physiological functions of spine. It is a "functional surgery" and an effective procedure for the patients with intraspinal tumors.

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  • 收稿日期:2021-06-17
  • 最后修改日期:2021-12-12
  • 录用日期:2022-01-20
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