NS / Cervical Laminoplasty (경추 척추 후궁 성형술) 수술 과정

Laminoplasty c-spine

multi-level cervical myelopathy

1. 척추후궁성형술

2. 추궁판성형술

 

 

 

 

velocity drill - 3mm cutting, diamond, fissure, 6mm cutting bur

rotating punch - 주로 2mm

micro pituatary 3ea, punch 1ea
Tripod

bipolar sharp / blunt 

 

micro setting 필요없음

 

 

 

 

 

 

 

 

1.position

prone - head secured in a Mayfield three-pin head-holder

 

2. midline posterior exposure 

->20mess incision

->assist: tooth 2ea

->bipolar bleeding control 하고 난 후 bovie로 lateral dissection, subperiostal plane을 따라 muscle expose 

->retractor : mastoid, 깊어지면 beckmann

->4*4 x-ray gz 사용

 

 

 

 

 

 

3.Open Side Trough Preparation 

lamina를 junction 따라 burr -  dorsal cortex - cancellous bone : 3mm cutting burr & 3mm diamond burr

Hemostasis of the bone surfaces : bone wax (ostene) 의 no.4 ele 

 

2mm sliding punch, 직각 punch, rotating punch 주로 사용.

가끔 5mm 직각 punch 

->ostene 의 no.4 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.Keeping the Door Open

주로 open door plate 사용 (파란색) 

->bender 는 kelly로 사용

->plate holder

 

 

 

 

 

 

 

 

5.Drill and Screw Insertion

hand drill or fissure bur -> screw 2.6* 5mm 

 

 

 

 

 

6.close

irrigation 

hemovac 400m 

1/0 vicryl -> 2/0 j vicryl -> skin stapler 

 

 

 

 

 

 

 

 

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http://www.mtortho.com/public/CENTERPIECE.pdf