The application of laminoplasty in the spinal cord tumors operation of adults

Abstract

Objective Laminoplasty has become a popular technique for the treatment of spinal cord tumors. The goal of this technique is to evaluate the effectiveness and biomechanical stability of Double-door and reconstructing of the laminae and relevant posterior elements used for adult spinal cord tumors resection. Method A series of 72 cases with spinal cord tumors removed through posterior approach from January 2006 to January 2008. During the operation, departing the para-vertebral muscle above the dorsal spine with preserving supraspinal ligament and interspinal ligaments, the laminae and relevant posterior elements were removed. After the tumor resection under microscope, the structure was replaced back to its previous levels and fixed with titanium miniplates. Drilling on spinous process, the para-vertebral muscle was suturing to its previous position. The surgical outcome of the procedure was analyzed, along with the neurological function after the operation. Long-term follow-up was performed to evaluate the spine stability. Results There were intramedullary ependenoma in 18 patients; intramedullary angioretieuloma in 6 patients; intradural-extramedullary Schwannoma neurilemmoma in 22 patients; intradural-extramedullary meningioma in 21 patients; congenital tumor (epidermoid cyst, dermoid cyst, teratoma, enterogenous cyst, liparomphalus) in 5 patients. A mean of 3.8 laminae levels (range from 2-6 levels) was exposed and reconstructed. 94. 4% of the tumors were totally removed. The follow-up rate was 37.5%; the follow-up period ranges from 6 months to 2. 5 years(average 11 months). All the follow-up patients received MRI and X-ray examination during 7 days to 2. 5 years after operation. There was kyphotic deformity in 1 patient in 2 years after operation. Conclusions Double-door and reconstructing of the laminae and relevant posterior elements, this modified technique provides a satisfactory operational field and has a low complication rate. Key words: Spinal neoplasms; Surgical procedures, operative