椎板回植及纤维蛋白封闭剂在椎管内肿瘤治疗中的应用
Chinese Journal of Reparative and Reconstructive Surgery（2008）
Abstract
目的介绍在治疗原发椎管内肿瘤时联合应用椎板棘突回植及纤维蛋白封闭剂的手术方法,并评价其疗效。方法2003年6月-2005年12月,采用椎板棘突回植术及纤维蛋白封闭剂治疗椎管内肿瘤16例,男7例,女9例;年龄26～55岁。病程1个月～2年。肿瘤位于胸段8例,胸腰段3例,腰段5例。主要表现为腰背部疼痛及下肢不全瘫。所有患者均行MRI检查为椎管内髓外硬脊膜内占位性病变。其中单发神经鞘瘤9例,脊膜瘤5例,多发神经鞘瘤、胶质瘤各1例。结果手术过程顺利,无术中并发症。术后行X线及CT检查,复合体回植物位置良好,无螺钉突破椎板压迫硬脊膜。术后全部获12～42个月随访,疼痛及瘫痪程度明显改善,恢复了生活及工作能力。3例患者复查MRI示硬脊膜结构清晰,无明显粘连及压迫征象。14例患者复查CT未见骨不愈合及回植的复合体移入椎管,椎板内侧缘骨质未因过度增生而对硬脊膜产生新的压迫。结论在行椎管内肿瘤摘除术的同时联合应用纤维蛋白封闭剂及椎板棘突回植术可维持脊柱的稳定性,保持椎管的完整性,避免继发性椎管狭窄的发生,提高手术效果。
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