骨质内入路实施椎管手术的设计及生物力学研究

Laminectomy is a normal operation of spinal surgery, but it is prone to be unstable postoperatively .Relevant scholars then tried hard to design many lanimoplasty methods in order to make up for the defects, but these laminoplasty methods always only retained a part of the muscles or ligaments of the spine, can not completely restore the stability of the spine, and postoperatory spinal instability or deformity still occurred .In all parts of the spine, cervical spine’s mobility is the largest, and it was easily to appear unstable or deformity after surgery.This study intends to combine relevant anatomy and imaging studies of the cervical spine, explore to complete an entirely new way of operation, keep all cervical muscle tendon adhesion, design a set of suitable instruments for the operation, and simulated the operation on a fresh corpse, verify its scientific nature and feasibility.Then, use randomized control experiment and finite element simulation, we tested the characteristics of the laminoplasty method.In order to eventually provide a more ideal for clinical way of cervical spine surgery, solve the problem which troubled for many years.

椎板切除术是脊柱脊髓外科的常规术式，但术后容易出现脊柱的不稳定和畸形。相关学者又设计了多种椎板成形术以期弥补该缺陷，但既往各种椎板成形术仅保留了脊柱部分肌肉或韧带的附着，并不能完全恢复脊柱的稳定系统，临床仍不断有术后发生脊柱不稳定或畸形的报道。在脊柱各部分中，颈椎活动度最大，最易在椎板手术后出现不稳定或畸形。本研究拟结合颈椎相关的解剖学、影像学等方面的研究，探索完成一种全新的手术方式，采用骨质内入路，利用骨质可以无瘢痕愈合的特点，保留颈椎肌肉韧带完整附着的同时，完整恢复椎体后方的解剖结构，设计一套适用于此术式的手术器械，并在新鲜尸体上进行模拟手术，验证其科学性及可行性。然后，通过随机分组的动物对照实验和有限元模拟实验，研究该术式的生物力学特征，判断其对颈椎稳定性的影响程度。以期最终能为临床提供一种比较理想的脊柱手术方式，解决脊柱脊髓外科手术领域多年来的一个难题。