Unilateral Laminotomy For Bilateral Decompression Of Lumbar Spinal Steosis Disease Anatomic Studies

[Objective]The paper is to research the treatment method of unilateral laminotomy for bilateral decompression(ULBD)of degenerative lumbar spinal canal stenosis by the anatomy.[Method](ULBD)method in the treatment of degenerative lumbar spinal stenosis.10 formalin fixed adult degenerative spine specimens are selected.Unilateral approach the specimens for bilateral decompression.CT scanning is performed before and after the operation.Research the effect of decompression area based on the maximum degree of protection of the spinal posterior structure through by measure the area of the spinal canal,spinal canal diameter(d diameter),and the maximum transverse diameter(w diameter).[Result]The operation is successfully completed,no damage of spinal posterior structure.1.Before the operation,the transverse diameter of vertebral endplate level is 16.373 ± 3.786 mm,the anteroposterior diameter of the spinal canal is 11.854±2.388 mm,and the area of vertebral canal is 158.504±54.287mm2.After the operation,the transverse diameter of vertebral endplate level is 20.107±2.890 mm,the anteroposterior diameter of the spinal canal is 20.056±3.523 mm,and the area of vertebral canal is 267.103±48.804 mm2.2.Before the operation,between the transverse diameter of spinal disc level is 15.331±3.799 mm,the anteroposterior diameter of the spinal canal is 11.385±2.510 mm,and the area of vertebral canal is 137.845±43.385mm2.After the operation,the transverse diameter of vertebral endplate level is 20.442±3.124 mm,the anteroposterior diameter of the spinal canal is 19.865±3.569 mm,and the area of vertebral canal is 288,300±46.268mm2.3.Before the operation,the level of inferior endplate of spinal canal diameter is 15.475 ± 3.677 mm,the anteroposterior diameter of the spinal canal is 11.313±2.710 mm,and the area of vertebral canal is 144.535±51.050mm2.After the operation,the transverse diameter of vertebral endplate level is 21.081±3.566 mm,the anteroposterior diameter of the spinal canal is 20.127±3.362 mm,and the area of vertebral canal is 288.383±55.706 mm2.The results have significant differences(P<0.01).T he results show that through to the end plate on the level,between disc and endplate under level three nodes for the various numerical increase d after operation.Can achieve the maximum from the viewpoint of anatomy to keep spinal posterior ligament complex and vertebral side under the premise of minimum damage to the dural sac and nerve root compression of purpose.[Conclusion]1.To preserve the lumbar posterior ligamentous complex in the maximum ex tent,unilateral approach for bilateral decompression can be effective t o the treatment of degenerative lumbar spinal stenosis.2.For unilateral approach bilateral decompression in the treatment of de generative lumbar spinal stenosis disease,Including upper vertebral lam ina decompression range should be 2/3,Lower lumbar vertebral body panels on a third or half lamina decompression,The lateral reserve lamina ist hmus,5 mm,Cortex contralateral vertebral plate to keep a single layer,and the contralateral pedicle for maximum stress range.3.Only a partial dissection of the side next to the vertebral muscles,R etain the contralateral vertebral side and yellow ligament spinal poster ior ligament complex structure,Small influence on the stability of the s pine.4.On the basis of keep the stability of the spine can keep spinal motio n,Reduced the adjacent segment degeneration due to internal fixation.