纳米人工椎板在脊柱后路手术中应用.docVIP

纳米人工椎板在脊柱后路手术中的应用 　　作者：张元和,卢伟,张明超 作者单位：辽宁医学院附属第一医院骨科，辽宁 锦州 121001 　　【摘要】目的 研究纳米人工椎板在脊柱后路手术中的应用。方法 本研究于2005年7月至2006年8月辽宁医学院附属第一医院骨科收集病例35 例，男21 例，女14 例。年龄41～62 岁，椎管狭窄16 例，椎管狭窄伴脊柱滑脱6 例，椎间盘突出12 例。行脊柱后路椎管扩大，人工椎板植入术，术后3 d，10 天检测生化全项，了解肝肾功能变化。术后定期随访复查，观察患者临床症状改善情况，同时摄X线片，了解椎弓根内固定及纳米人工椎板的位置。部分患者行CT检查。结果34 例手术切口Ⅰ/甲愈合。术后生化全项检测提示肝肾功能无明显变化。3 个月随访的30 例病例中， 28 例患者恢复良好。复查X线提示脊柱序列良好，行椎弓根内固定者内固定可靠，部分复查CT患者可见纳米人工椎板位置良好。结论 纳米人工椎板在预防脊柱后路手术瘢痕形成和保持脊柱后部结构稳定性方面具有明确作用。 　　【关键词】 纳米人工椎板 脊柱 椎板切除 瘢痕形成 　　Application of Nano-artificial Vertebral Lamina　in Vertebral Operation Via Rear Way 　　ZHANG Yuanhe, LU Wei, ZHANG Mingchao 　　(Department of Orthopedics, the First Affiliated Hospital of Liaoning Medical University, Jinzhou 121001 China) 　　Abstract: Objective To study the clinical effects of nano-artificial vertebral lamina on vertebral operation via rear way. Methods 35 patients were treated with nano-artificial vertebral lamina in the First Hospital affiliated to Liaoning Medical University between July 2005 and August 2006.Within the 35 cases,there were 21 males and 14 females，aging from 41 to 62.16 cases had spinal stenosis，6 cases had spina1 stenosis with spondylolysis and 16 cases had lumbar disk herniation materia1.The biochemistry examination，X-ray and CT were used regularly after the operation. Results First intension was achieved in 34 cases. The biochemistry examinations were normal after operation. Postoperative outcomes were satisfactory when 28 Patients were followed up for 3 month. Postoperative radiological evaluation revealed that implants were stable. Conclusions The nano-artificial vertebral laminae can effectively prevent scar formation and demonstrably reconstruct the structure of vertebra. 　　Key words：nano-artificial vertebral lamina;vertebral; scar formation; Laminectomy 　　椎板切除术是某些脊柱退形性疾病及部分脊柱后柱创伤中开展较多的术式，大多数患者的症状在术后能得到长期的缓解，但有一些患者术后疼痛复发等症状，其主要原因之一就是椎板切除部硬脊膜和神经根周围的纤维化,大量的瘢痕使硬脊膜和神经根与周围组织,特别是背侧的骶棘肌粘连在一起,牵扯、压迫神经而引起。近年来我们在部分脊柱后路手术中使用纳米人工椎板，探讨其预防瘢