椎板回植微型钛板螺钉固定术在老年椎管内肿瘤病人中的疗效研究

doi:10.3969/j.issn.1003-9198.2025.11.010

摘要/Abstract

摘要： 目的探讨椎板回植微型钛板螺钉固定术在老年椎管内肿瘤病人中的应用效果。方法对2020年1月至2024年2月期间在南京市浦口人民医院脊柱外科行椎管内肿瘤切除椎板回植的老年病人进行回顾性分析,根据术中内置物不同将病人分为微型钛板螺钉内固定组和椎弓根螺钉内固定组,统计2组病人年龄、性别、手术时间、出血量、术后引流量、美国脊柱损伤协会脊髓损伤神经功能(ASIA)分级情况、术后脑脊液漏发生率、椎管矢状位直径以及VAS、Oswestry功能障碍指数(Oswestry disability index,ODI)评分并比较。结果本研究共纳入78例病人,42例采用椎板回植微型钛板螺钉固定术(A组),36例采用椎板回植椎弓根螺钉固定术(B组)。与B组相比,A组手术时间和术中出血量显著减少(P＜0.05)。2组病人术后1周及1年VAS评分、ODI评分均较术前显著降低(P＜0.05),术后1年VAS评分、ODI评分较术后1周显著降低(P＜0.05),且术后1年A组VAS评分较B组降低(P＜0.05)。病人术后症状及体征较术前均有显著改善,椎板均达到骨性愈合。结论对于老年椎管内肿瘤病人,微型钛板螺钉内固定具有缩短手术时间、减少出血量、降低远期疼痛程度的优势。

关键词: 胸腰椎, 椎管内肿瘤, 椎板回植, 老年人, 微型钛板

Abstract: Objective To investigate the clinical effect of lamina replantation with mini-titanium plate and screw internal fixation in the elderly patients with intraspinal tumors. Methods The clinical data of the elderly patients who underwent intraspinal tumor resection and lamina replantation in Department of Spine Surgery of Nanjing Pukou People’s Hospital from January 2020 to February 2024 were retrospectively analyzed. The patients were divided into mini-titanium plate and screw internal fixation group(group A) and a pedicle screw internal fixation group(group B). The age, gender, operation time, blood loss, postoperative drainage volume, American Spinal Injury Association(ASIA) grade, postoperative cerebrospinal fluid leakage, spinal sagittal diameter, Visual Analogue Scale(VAS) score, Oswestry disability index(ODI) score were recorded and compared between the two groups. Results A total of 78 patients were enrolled in this study, with 42 cases in group A and 36 patients in group B. Compared with group B, the operation time and intraoperative blood loss in group A were significantly reduced(P<0.05). The VAS score and ODI score of the two groups 1 week and 1 year after surgery were significantly lower than those before surgery (P<0.05), and the VAS score and ODI score 1 year after surgery were significantly lower than those 1 week after surgery (P<0.05). Furthermore, the VAS score in group A 1 year after surgery was significantly reduced than that in group B (P<0.05). After operation, the symptoms and signs of the patients were significantly improved. The vertebral plates were fully bony healed. Conclusions For the elderly patients with spinal canal tumors, micro titanium plate and screw internal fixation has the advantages of shortening the operation time, reducing the bleeding, and reducing the long-term pain degree.

Key words: thoracolumbar vertebtae, spinal canal tumour, vertebral plate implantation, aged, micro-titanium plate

中图分类号:

R 739.42

李威霖, 冯玉旭, 余利鹏, 吴宗方, 赵峰, 陈福扬. 椎板回植微型钛板螺钉固定术在老年椎管内肿瘤病人中的疗效研究[J]. 实用老年医学, 2025, 39(11): 1121-1124.

LI Weilin, FENG Yuxu, YU Lipeng, WU Zongfang, ZHAO Feng, CHEN Fuyang. Efficacy of lamina replantation with mini-titanium plate and screw internal fixation in elderly patients with intraspinal tumors[J]. Practical Geriatrics, 2025, 39(11): 1121-1124.

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