Abstract
Introduction. Intraspinal tumours are rare and principally managed surgically. Laminectomy, employed for access to the spinal canal, destroys the posterior tension band leading to a risk of kyphosis. Hemilaminectomy as an alternative may be less destructive, potentially reducing the risk of deformity and causing less post-operative pain. Method. We investigated this hypothesis by retrospectively reviewing a case series of 56 surgeries for a disparate and unselected group of intraspinal tumours utilizing a laminectomy or hemilaminectomy approach. Results. No difference was found in length of operation, completeness of resection, complication rate and Frankel-score improvements. Hemilaminectomy (n = 22) is associated with reduced hospital stay (post-op days) 4.5 (2–6) versus 6 (3–8), (p = 0.026, Mann–Whitney), and a reduction in post-operative morphine use (mg) 10 (3.5–28) versus 30 (10–90), (p = 0.005, Mann–Whitney).Post-operative kyphosis was measured with the Harrison posterior tangent method on T2-weighted sagittal MR images. The average change in kyphosis angle was greater in the laminectomy group compared with the hemilaminectomy group, 3.6 (0.8–6.2) versus 0.4 (-0.2–1.2), statistically significant (p = 0.004, Mann–Whitney). Conclusion. Hemilaminectomy is as effective an access procedure for the resection of unselected intraspinal tumours as laminectomy, but is associated with shorter post-operative stays, lower analgesic requirements and less post-operative kyphosis.
Published Version
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