Clinical application of para-split laminotomy in the treatment of lumbar spinal canal tumors

Abstract

Objective To explore the feasibility and effectiveness of para-split laminotomy in the treatment of lumbar spinal canal tumors. Methods We retrospectively reviewed the clinical data of 15 patients with lumbar spinal canal tumors who underwent tumor resection following para-split laminotomy at Department of Neurosurgery, Clinical Medical College of Yangzhou University from October 2016 to May 2018. Observation indicators included intraoperative blood loss, surgical duration, tumor resection, tumor pathological results and complications.Neurological functions of the spinal cord evaluated based on JOA (Japanese Orthopedic Association) scoring system. The follow-up situations included tumor recurrence, spinal stability evaluation and bone fusion of laminae. Results All lumbar spinal canal tumors were resected completely. The mean blood loss was 95.3±58.2 ml and the mean duration of the surgical procedure was 176.7±35.2 min. In this group, the average preoperative JOA score was 15.5±4.9 and the average postoperative JOA score was 24.0±3.5, which was improved significantly (P<0.01). There were no operative complications occurring. The CT examination showed no pedicle or vertebral fractures. During the follow-up period of 6-18 months (average: 10.8±3.9 months), no tumor recurrence or spinal deformation was found according to the imaging examination. CT examination showed that the split laminae tended to heal in the operative area. Conclusion The para-split laminotomy shows minimally invasive damage to the posterior spinal tension band and helps to protect the stability of the spine. It is feasible and effective to apply the para-split laminotomy in the operation of lumbar spinal canal tumors. Key words: Spinal canal; Neoplasms; Neurosurgical procedures; Laminotomy