Single open-door laminoplasty microsurgery for the treatment of cervical intradural extramedullary tumors

Abstract

Objective To investigate the feasibility and clinical efficacy of single pen-door laminoplasly and reconstruction of the posterior structure of spinal canal for the treatment of cervical intradural extramedullary tumors. Methods From January 2001 to January 2013, 87 patients with cervical intradural extramedullary tumor were treated by using the single open-door laminoplasty, reconstruction of the spinal posterior structure method, and 78 of them were treated with the single open-door setting off lamina, microsurgical resection of intraspinal occupying, lamina and spinous process complex in situ reduction, 9 were treated with single open-door laminoplasty and reconstruction of the spinal canal with mini titanium plate fixation after removal of the tumors. Results They were followed up for 12 to 58 months (mean 26.3 months). The numbers of lamina open-door segments were 2 to 5 (mean 2.5). The mean operation time was 92 min (range 62-136 min); the intraoperative mean blood loss was 80 ml (range 50-260 ml). The postoperative clinical symptoms of the patients disappeared completely or mostly. Postoperative X-ray examinations of all cases did not show the signs of spinal instability, CT scan of 63 cases revealed that spinous process-lamina complex of reduction did not have invagination and displacement. MRI of 75 cases showed that their cervical intradural extramedullary tumors did not have recurrence. No spinal canal stenosis, yellow ligament, and dura thickening were observed. The changes of spinal curvature: cervical curvature decreased from preoperative 17.8±8.4° to 16.1±7.8° at 12 months after procedure. There was no significant difference between before procedure and after procedure (P>0.05). Conclusions Single open-door laminoplasty for the treatment of cervical intradural extramedullary tumor has satisfactory effect for tumor exposure and resection, at the same time; it saves the continuity of the lamina on one side. After spinous process-lamina complex of reduction, the original anatomical structures of spinal were recovered. It has little impact on the stability of the spine and can avoid the occurrence of spinal deformity after laminectomy. Key words: Intraspinal tumor; Microsurgery; Single open-door laminoplasly