颈椎椎板切除融合术(Cervical - Cervical Laminectomy, Fusion)

颈椎椎板切除术去除椎体的棘突和椎板以消除对脊髓的压迫。压迫往往源自椎管狭窄症(椎管变细导致脊髓或神经受压)。在骨头去除后,可能另外需要骨移植对椎体进行融合,为脊柱提供稳定。

Introduction(介绍)

  A cervical laminectomy removes the spinous process and lamina from a vertebra to eliminate pressure on the spinal cord. The source of the pressure is often spinal stenosis, a condition in which there is a narrowing of the spinal canal that causes pressure on the spinal cord or nerves. After removing bone, bone grafts can be added to fuse the vertebrae and provide stability to the spine.

  颈椎椎板切除术去除椎体的棘突和椎板以消除对脊髓的压迫。压迫往往源自椎管狭窄症(椎管变细导致脊髓或神经受压)。在骨头去除后,可能另外需要骨移植对椎体进行融合,为脊柱提供稳定。

Incision & Removal(切口和切除)

  An incision is made along the midline at the back of the neck. After the spine is exposed, surgical instruments are used toremove the spinous process and lamina from the affected vertebrae. Another variation of this step involves using a motorized instrument to cut a trough through the lamina on both sides of the vertebra and removing the lamina and spinous process as a single piece. A surgical microscope is often used during this procedure to ensure a high degree of accuracy.

  在颈后部沿中线作一切口。在脊柱暴露后,用手术器械将棘突和椎板从相应椎体上切除。这一步另外一种方法是用动力设备在椎板两侧开槽,将棘突和椎板整块取下。在这一步中,经常使用手术显微镜来保证高度的精确性。

Preparing for Fusion(准备融合)

  A motorized instrument (bur) is used toremove the top (cortical) layer of the articular processes (spine joints) at the sides of the vertebrae to prepare a site for fusing the vertebrae. The fusion will stabilize the spine where bone was removed.

  用动力设备(磨钻)将椎体侧面的关节突(颈椎关节)的表层皮质骨去除,准备骨融合的植骨床。融合可以稳定作了骨切除的脊柱。

Graft Placement(植骨)

  Bone grafting can be done with pieces of a patient’s own bone (autograft), processed bone from a bone bank (allograft), or a bone graft substitute (demineralized bone, ceramic extender, or bone morphogenetic protein). When a patient’s own bone is used for grafting, the pieces are typically crafted from the bone components that were removed previously (local bone graft). Bone grafts are placed along the prepared site where the top layer of bone was removed. This bone eventually grows in place, fusing the spine and providing additional stability.

  移植骨可以用自己身上的碎骨块(自体骨移植)、来自骨库的加工骨(同种异体骨)或骨移植材料(脱钙骨、多孔陶瓷、骨形态发生蛋白等)。当用病人自己的骨头移植时,往往由先前取下的那部分骨头制作(局部骨移植)。骨移植物沿先前去除了外层皮质的骨头放置,最终,这些骨头会长到一起使脊柱融合稳定。

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 recovery.

  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。


    2017/2/27 10:57:53     访问数:408
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