CRITICAL ANALYSIS OF EXTENSIVE CERVICAL LAMINECTOMY
CRITICAL ANALYSIS OF EXTENSIVE CERVICAL LAMINECTOMY
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DOI：
10.1227/00006123-198902000-00010
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发表时间：
1989-02-01
期刊：
影响因子：
4.8
通讯作者：
HATTORI, Y
中科院分区：
文献类型：
--
作者：
ISHIDA, Y;SUZUKI, K;HATTORI, Y
传统的广泛椎板切除术已广泛用于减少脊髓压迫，并且通过使用气钻可以大大方便。然而，椎板切除术被认为是术后问题的偶然原因，例如脊柱不稳定或畸形、加速脊柱变性、硬膜外疤痕形成引起的硬脑膜收缩以及脊髓后部骨保护的缺乏。为了消除传统椎板切除术的这些负面影响，人们使用了一种称为悬吊椎板切开术的手术技术。对 55 例接受传统广泛椎板切除术治疗的患者和另外 55 例接受悬吊椎板切除术治疗的患者进行了临床随访和比较。通过平面X光片评估颈椎的灵活性和排列，并通过计算机断层扫描评估硬脑膜配置。还评估了神经系统的改善。观察到椎板切除术后脊柱运动减少，特别是在伸展过程中，可能是由于椎旁肌肉功能不足所致。与传统椎板切除术治疗的患者相比，采用悬吊椎板切除术治疗的患者术后脊柱畸形的发生率较低，硬脊膜缩窄的缓解效果更好。 Neurological recovery was significantly better in fully decompressed cases than in insufficiently decompressed cases.
Conventional extensive laminectomy has been widely performed to reduce spinal cord compression, and is greatly facilitated by the use of an air drill. Laminectomy is recognized, however, as the occasional cause of problems after surgery, such as spinal instability or deformity, acceleration of spondylotic change, constriction of the dura mater caused by extradural scar formation, and lack of posterior bony protection for the spinal cord. In an effort to eliminate these negative aspects of conventional laminectomy, a surgical technique called suspension laminotomy has been used. Fifty-five patients treated with conventional extensive laminectomy and 55 others treated with suspension laminotomy were followed up clinically and compared. Flexibility and alignment of the cervical spine were assessed by plane radiographs, and dural configuration by computed tomographic scans. Neurologic improvement was also evaluated. Decrease of spinal movement after laminectomy was observed, notably during extension, probably as a result of functional insufficiency of paraspinal muscles. The incidence of postoperative spinal deformity was lower and the relief of dural constriction better in the patients treated with suspension laminotomy than in those treated with conventional laminectomy. Neurological recovery was significantly better in fully decompressed cases than in insufficiently decompressed cases.