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Thoracic Laminectomy and Instrumentation 胸椎椎板切除内固定术 Introduction （介绍） A narrowing of the spinal canal can cause painful pressure on the spinal cord or nerves. Sometimes the source of this narrowing is a tumor that has spread to the thoracic region of the spine and is pushing on the spinal cord. A thoracic laminectomy removes the lamina from vertebral bodies, providing access to remove the tumor and eliminate pressure on the spinal cord. After removing bone, instrumentation can be added to stabilize the vertebrae. 椎管狭窄压迫脊髓或神经会产生疼痛。有时，引起狭窄的原因是肿瘤扩散到脊柱的胸段，压迫脊髓。胸椎椎板切除术将椎板从椎体上切除，为切除肿瘤提供入路并解除脊髓的压迫。在骨切除后，可使用内植物以稳定脊柱。 Incision & Removal（切口和切除） An incision is made along the middle of the back. Once the spine is exposed, surgical instruments are used to remove the spinous processes. Next, the lamina portions of affected vertebrae are removed, providing access to the tumor. 在后背正中作切口。当脊柱显露完毕，使用手术器械将棘突去除。然后，切除与椎体相连的椎板，以显露肿瘤。 Tumor Removal （切除肿瘤） Surgical instruments are used to remove the tumor. Removing both the tumor and overlying bone that was pushing it into the spinal cord relieves the compression and pain. 用手术器械将肿瘤切除。同时将肿瘤和表面压迫脊髓的骨头去除，解除压迫，缓解疼痛。 Stabilizing the Spine （稳定脊柱） Instrumentation is introduced to support the spine. Holes are made in the pedicle of intact vertebrae and screws are placed in the drilled holes. Next, rods are positioned between the screws and fastened in place. The rod and screw instrumentation provides stability to the spine. 用内植物支撑脊柱。在相邻的椎体的椎弓根部位钻孔，沿着孔拧入螺钉。然后，在螺钉之间安装连接棒并固定。钉棒内固定装置为脊柱提供稳定性。 Summary （总结） The incision is closed and dressed to complete the surgery. Radiation treatments are frequently used 2-4 weeks after surgery to treat any tumor remaining in the spine. Adding the instrumentation after the laminectomy increases the strength of the spine and may decrease the need for a post-operative brace. Patients should avoid heavy lifting, bending, twisting, and turning for six to twelve weeks. 关闭切口并包扎，完成手术。术后2~4周后往往开始行放射治疗，以杀灭脊柱残留的肿瘤。椎板切除术后附加内固定增加脊柱的强度，减少术后支具的使用。在术后6~12周内患者避免负重、弯腰、扭腰及转身等动作。 （高晨珉 转） |
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