Vertebral plate and ligament composite laminoplasty in spinal cord tumor surgery: Analysis of 94 patients.

Xu Hao,Wang Lin

doi:10.1515/tnsci-2021-0007

Xu Hao, Wang Lin

Open Access

https://doi.org/10.1515/tnsci-2021-0007

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Abstract

ObjectivesThe aim of this study was to evaluate the value and long-term effect of laminectomy or laminoplasty in spinal cord tumor surgery.Patients and methodsPatients with spinal cord tumor treated in Department of Neurosurgery from January 2016 to October 2019 were included in this study. Posterior median approach tumor resection was preceded in 94 cases. Vertebral plate and ligament composite replant (laminoplasty group) was proceeded in 34 cases, and vertebral plate resection (laminectomy group) was proceeded in 60 cases. All patients were followed up and neurological function imagings were conducted 1 week, 3 months, and 6 months postsurgery to evaluate the surgical efficiency and spinal stability.ResultsTotal resection was achieved in 84 patients (89.0%); subtotal resection was achieved in 10 patients (11%). There was no significant difference between thelaminectomy group and laminoplasty group in terms of operative time, surgical site, infection rate, cerebrospinal fluid (CSF) infection, CSF leak, and length of hospitalization (P > 0.05). The incidence of postoperative spinal deformity was 15.0% in the laminectomy group and 11.7% in the laminoplasty group (P > 0.05). Laminoplasty vs laminectomy was associated with a similar risk of progressive deformity. However, for the cervical patients, there is significant difference (P < 0.05) in the spinal deformity. For the patients with incision vertebral segments >3, there is no significant difference in the spinal deformity (P > 0.05). Bone fusion was achieved in 7 (20%) patients in the laminoplasty group. Laminoplasty vs laminectomy was associated with a similar risk of progressive deformity.ConclusionVertebral plate and ligament composite replant is a simple and practical method in spinal cord tumor surgery. Neither every case got bone fusion nor positive results turned out in survival analysis, but it is still valuable in reducing spinal deformity, especially in cervical vertebra spinal cord tumor surgery.

Highlights

Intradural spinal tumor is the most common spinal tumor, accounting for 4.3–10.4% in central nervous system tumor [1]
Laminoplasty is considered as a practical method to reconstruct normal anatomical structure, preserve spinal stability, and prevent kyphosis compared to laminectomy
The aim of this study is to explore the difference between laminoplasty and laminectomy in short-term prognosis, neurofunction recovery, and the incidence and time of spinal deformity occurrence

Summary

Introduction

Intradural spinal tumor is the most common spinal tumor, accounting for 4.3–10.4% in central nervous system tumor [1]. While posterior median approach is the most common method, both laminectomy and laminoplasty were well used in the procedure. Previous research indicated that the progressive spinal deformity would deteriorate the long-term function in many cases. The deformity rate is 7–20%, according to different studies [2,3,4,5], and for children the deformity rate could be 20–100% [5,6,7,8]. Laminoplasty is considered as a practical method to reconstruct normal anatomical structure, preserve spinal stability, and prevent kyphosis compared to laminectomy. The aim of this study is to explore the difference between laminoplasty and laminectomy in short-term prognosis, neurofunction recovery, and the incidence and time of spinal deformity occurrence

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Conclusion