Spinal canal reconstruction with autologous spinous process-lamina complex replanted and fixed by titanium sheet and pins after resection of intraspinal tumors

Abstract

To explore the therapeutic effects of Spinal canal reconstruction with autologous spinous process-lamina complex replanted and fixed by titanium sheet and pins after resection of intraspinal tumors. Among 15 patients with intraspinal tumors at our hospital from July 2011 to December 2013, there were schwannoma (n = 11), spinal meningioma (n = 1), ependymoma (n = 1) and epidermoid cyst (n = 2). All resections were performed via a posterior midline approach. And the clinical data were analyzed. The spinous process and lamina complex were resected en bloc by burr drill and reserved with interior sclerotin bitted. Then replantation in situ and fixation by titanium sheet and pins were performed after a resection of intraspinal tumors and skeletal fragment was replanted into bone gaps. Laminoplasty were finished and other procedures were the same as laminectomy. Computed tomography 3-demsional reconstruction, magnetic resonance imaging (MRI) and pathological examination were performed before and after operations. Wound healing, spinal integrity, stability and activity were evaluated. Sagittal diameters of spinal canal lumina in operative area were measured and analyzed statistically. Fifteen tumors in 15 patients were totally resected while preoperative symptoms improved significantly or disappeared. Incision stitches were removed at days 7-9 post-operation with excellent healing. There was neither cerebrospinal fluid leakage nor local or systemic rejection. During a follow-up period of 3 to 24 months, there was an onset of such subjective discomforts as distraction, contracture and foreign body sensation. No spinal stenosis, collapse or displacement of replanted tissues occurred. Spinal capacities and shapes were plump. There was no collapse and displacement along healed lamina bony. CT and MRI results were satisfactory. No significant difference was found between peri- and post-operative sagittal diameters of spinal canal lumina (P > 0.05). After resection of intraspinal tumors, spinal canal reconstruction with autologous spinous process-lamina complex reduction is both simple, practical and effective for protecting spinal integrity, stability and activity.