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骨科手术早知道088:颈椎椎板成形术(Cervical - Cervical Laminoplast...


  颈椎椎板成形术用于解除颈椎管狭窄引起的脊髓和神经的压迫。颈椎管狭窄是颈椎椎管变细引起的一类疾病。椎板成形术在一侧椎板做成合页,扩大椎管空间,从而解除脊髓的压迫。



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Introduction (介绍)

A cervical laminoplasty is performed to remove pressure on the spinal cord and nerves caused by spinal stenosis, a condition in which there is a narrowing of the spinal canal. The laminoplasty procedure involves making a hinge on one side of the lamina to create more space, relieving the pressure on the spinal cord.

  颈椎椎板成形术用于解除颈椎管狭窄引起的脊髓和神经的压迫。颈椎管狭窄是颈椎椎管变细引起的一类疾病。椎板成形术在一侧椎板做成合页,扩大椎管空间,从而解除脊髓的压迫。


Incision and Channel Creation (切口和开槽)

An incision is made in the back of the neck. A motorized instrument is used to cut 2 channels vertically on the lamina portion of the vertebrae. On one side the channels are cut all the way through the bone. On the opposite side, the channel is only cut 50% to 75% though the bone to create a hinge. The side causing the most pressure on the spinal cord or nerves is typically the side where the channels are cut entirely through the lamina. The tips of the spinous processes are also typically removed.

  在颈后部作切口,用动力设备在颈椎两侧椎板各作一条垂直的槽,一侧将椎松完全切断,对侧只切开50%到75%,形成一个合页。对脊髓或脊神经构成主要压迫的一侧往往作椎板完全切断。倾斜的棘突往往予以切除。


Rotation (旋转)

The lamina is then lifted and rotated. This increases the space for the spinal cord, relieving the compression that causes pain.

  然后将椎板抬高旋转,这样就增加了脊髓的空间,缓解压迫引起的疼痛。


Maintaining the Opening (维持开门)

Maintaining the hinged door opening can be done in various ways. Some procedures use suture tied from the spinous process to the side of the spine, some use small wedges of bone graft, and some procedures screw specialized metal plates into position to keep the lamina in the elevated, rotated position.

  有多种方法用来维持椎板开门的打开。有些用缝线将棘突绑到颈椎的一侧,有些用小楔形植骨,有些用特殊的钢板螺钉固定维持椎板旋转后移的位置。


Summary (总结)

The incision is closed and dressed to complete the procedure. A cervical collar is often worn for 6 weeks following surgery. Patients should be careful to avoid heavy lifting and excessive neck motion during the recovery period.

  关闭切口并包扎,完成手术。术后常常佩戴颈托6周。愈合过程中,患者应避免负重和颈部过度的活动。

(胡佰文   



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