Application of open-door laminoplasty with ARCH plate fixation in cervical intraspinal tumors

Zhi-Chao Wang,Ting Wang,Chu-Qiang Yin,Yuan-Liang Sun,Xin-Fei Qu,Jie Wang,Zhen-Lu Cao,Yue-Lei Wang,Chen-Jing Liu,Shu-Zhong Li

doi:10.1186/s12893-021-01140-3

Zhi-Chao Wang, Ting Wang + Show 8 more

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https://doi.org/10.1186/s12893-021-01140-3

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Abstract

BackgroundThe open-door laminoplasty is an effective procedure for the treatment of cervical spondylotic myelopathy. However, little information is available about the surgical results of open-door laminoplasty in the treatment of intraspinal tumors. In the present study, we aimed to investigate the clinical effect of open-door laminoplasty with ARCH plate fixation in the treatment of cervical intraspinal tumors.MethodsThis was a retrospective study. From January 2013 to May 2018, 38 patients (13 males and 25 females, the average age of 44 ± 17 years) with cervical intraspinal tumors underwent open-door laminoplasty with ARCH plate fixation in our hospital. The operation time, blood loss, pre- and postoperative visual analog scale (VAS), and Japanese Orthopedic Association (JOA) scores were determined. To determine the radiographic outcomes, cervical X-ray film and magnetic resonance imaging (MRI) were performed before and after the operation, and cervical X-ray sagittal film was used to measure Cobb angle. The clinical data before and after the operation were compared by t-test.ResultsA total of 38 patients underwent a successful operation and demonstrated primary healing. The average operation time was 113 ± 12 min. The average blood loss was 120 ± 19 mL. All patients were followed up for 26.1 ± 2.8 months, and the final follow-up time was more than 24 months. VAS scores were much better at 24 months after operation compared with those before the operation, which were decreased from 6.1 ± 1.1 to 1.4 ± 0.7 (t = 32.63, P < 0.01). The JOA score was improved from 9.9 ± 1.5 to 15.5 ± 0.6 (t = − 18.36, P < 0.01), and the mean JOA recovery rate was 79% ± 11% at 24 months after the operation. There was no significant difference in Cobb angle between pre-operation and 24 months after the operation, which was 9.8 ± 2.6 and 10.3 ± 3.1 respectively (t = − 0.61, P > 0.05). Neither spinal malalignment on the coronal plane nor displacement of the laminoplasty flap was observed on postoperative cervical X-ray and MRI examinations at the final follow-up.ConclusionsOpen-door laminoplasty with ARCH plate fixation was a safe and effective surgical approach for the treatment of cervical intraspinal tumors.

Highlights

The open-door laminoplasty is an effective procedure for the treatment of cervical spondylotic mye‐ lopathy
Zong et al [4] have reported that the total laminectomy and screw-rod internal fixation significantly reduced the incidence of spinal structural instability and kyphosis to some extent, comparing with the classical total laminectomy, in short-term follow-up
We aimed to investigate the clinical effect of open-door laminoplasty with ARCH plate fixation in the treatment of cervical intraspinal tumors

Summary

Introduction

The open-door laminoplasty is an effective procedure for the treatment of cervical spondylotic mye‐ lopathy. We aimed to investigate the clinical effect of open-door laminoplasty with ARCH plate fixation in the treatment of cervical intraspinal tumors. The biomechanical stability of the spine is most affected by the removal of the posterior column structure of the spine. This situation usually leads to spinal structure instability and kyphosis, especially for patients with cervical intraspinal tumors [1,2,3]. Due to the loss of posterior bone structure, the scar tissue is still the risk of spinal cord compression after operation [1, 5, 6]

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