| Objective: with the help of human specimens, and a qualitative study in different spine segment anatomical titanium mini plate system, so as to completely attached to the lamina, lower notch; after the biomechanical experiment, verify that this system meets the biomechanics of human body, whether can achieve the corresponding strength and to provide enough supporting force; to be meet the standards after implantation of human experiments, the mini titanium plate for lamina osteotomy replantation in situ, application situation were recorded at different time points after operation, the clinical follow-up of patients, the occurrence of complications of nerve recovery was observed in patients with postoperative fixation related degree and, through statistical analysis to gain the mini titanium plate system in recapping final effect of grafting.Methods: design and drawing by our department of titanium mini plate, to cooperate in the production samples with domestic equipment company. Department of orthopedics, the Third Hospital of Hebei Medical University and research institute cooperation, related biomechanical experiment of mini titanium plate after implantation, to test whether accord with mechanical standards. In accordance with the standards of the patient selection into this clinical experiment, verification of mini titanium plate in the recapping laminoplasty safety and efficacy of intraoperative. Control of miniature titanium board cost, make the low income patients also can receive treatment. Study methods adopted, technical route, the experiment scheme and feasibility analysis of miniature titanium board design and drawing, sample preliminary shaping, biomechanical, products related to applied to modify the recapping laminoplasty in operation, to meet the inclusion conditions of the previous operation patients with clinical follow-up, records and related indicators were observed after 1, 3, 6, 12, 24 months of analysis and summary of each patient nerve function recovery and complication rate, to maintain the stability of the spinal column sequence occurred, with the aid of statistical analysis software, that the end result.Results: the lamina osteotomy replantation in situ technology is an effective surgical treatment of intraspinal benign tumor, the previous literature has reported in detail, it can maintain the integrity of the spinal canal, prevent postoperative scar formation again the compression of the spinal cord caused neurological symptoms, the overall curative effect is better than that of non replantation in control group [1,2]. The director of our department Hu Cheng- dong modified for its treatment of multi segmental stenosis ossification of ligamentum flavum in thoracic tube. Fir. First of all to ultra-thin grinding drill for bilateral "slotted" on the compression part of lamina, the whole "uncovering method" opened the lamina [3] and lamina in the removal of ossification, in situ replantation with mini titanium plate fixation after bilateral. This technique has the following advantages: operation under direct vision, the decompression process to avoid the "nibbling" and "chisel division" on the spinal cord to produce impact and shock; the facet joint of most of the structure is preserved, while bilateral titanium plate fixation, can be avoided to the greatest extent of occurrence of spinal instability; the back plant lamina provides a mechanical barrier to the spinal cord, the spinal cord from scar tissue compression; keep the spinous process provides a point of attachment for the back muscle tissue, can effectively prevent muscle atrophy. In operation gradually mature and widely used in clinical development at the same time, I Division also actively explore a new anatomical mini titanium board system, which helps to simplify the operation steps, to provide a stable support and fixation for replantation of lamina, promote bone fusion. Recapping laminoplasty with mini titanium plate forming and application can be a stenosis patients with intraspinal benign tumor or thoracic spinal canal provides a new choice, operation at the same time, the new mini titanium plate system implantation can make the thoracolumbar reach can be stable, which can shorten the patient’s bed and hospitalization time, also reduced the nursing cost of patients families, in line with the party and the government to call for policyConclusion: the new mini titanium plate is applied to obtain the effect of replantation of lamina clinical confirmed, can be used as a method of choice for the treatment of multiple segmental thoracic ossification of ligamentum flavum, it can maintain the integrity of the spinal canal, prevent postoperative scar formation again the compression of the spinal cord causing neurological symptoms; this type of operation can also avoid the postoperative the occurrence of instability, thoracic kyphosis, loosening of internal fixation and re operation. At the same time, the successful development of new titanium plate will produce great social value, through the control of the product price can serve the vast number of low-income patients. |
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