Turkish neurosurgery · 2013
Hemilaminectomy approach combined with in situ restoration of vertebral laminae for thoracic intraspinal tumors.
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Li Wen-Sheng, Chen Chuan, Wang Hui, Liang Chao-Feng, Luo Lun, Guo Ying
Аннотация
AIM: This study aims to evaluate the hemilaminectomy approach and in situ restoration of vertebral laminae in microsurgery for thoracic intraspinal tumors.
MATERIAL AND METHODS: Sixteen patients with thoracic intraspinal tumors, consisting of 6 males and 10 females with a mean age of 47.5±16.4 years ranging from 21 to 71 years, underwent surgical treatment with hemilaminectomy approach and in situ restoration of vertebral laminae. All patients were followed up after surgery for 12 to 30 months, involving Frankel grade, spinal instability, and deformity.
RESULTS: Mean operation time was 119.5±23.0 minutes. Laminotomy was performed with one vertebral plate in 2 cases, two vertebral plates in 12 cases, and three vertebral plates in 2 cases. Postoperative three-dimensional CT scanning revealed a stable bony reconstruction, and no cerebrospinal fluid leakage or subcutaneous hydrops. Surgical pathology was consistent with preoperative MRI diagnosis. With respect to neurological status, the percentage of good Frankel scale was markedly improved from 37.5% on admission to 81.3% at follow-up (p < 0.05). None of the subjects showed spinal deformity or instability.
CONCLUSION: In situ restoration of vertebral laminae maximally preserves the spinal integrity and stability, and reduces postoperative complications including cerebrospinal fluid leakage, pseudomeningocele, spinal deformity, and instability.
MATERIAL AND METHODS: Sixteen patients with thoracic intraspinal tumors, consisting of 6 males and 10 females with a mean age of 47.5±16.4 years ranging from 21 to 71 years, underwent surgical treatment with hemilaminectomy approach and in situ restoration of vertebral laminae. All patients were followed up after surgery for 12 to 30 months, involving Frankel grade, spinal instability, and deformity.
RESULTS: Mean operation time was 119.5±23.0 minutes. Laminotomy was performed with one vertebral plate in 2 cases, two vertebral plates in 12 cases, and three vertebral plates in 2 cases. Postoperative three-dimensional CT scanning revealed a stable bony reconstruction, and no cerebrospinal fluid leakage or subcutaneous hydrops. Surgical pathology was consistent with preoperative MRI diagnosis. With respect to neurological status, the percentage of good Frankel scale was markedly improved from 37.5% on admission to 81.3% at follow-up (p < 0.05). None of the subjects showed spinal deformity or instability.
CONCLUSION: In situ restoration of vertebral laminae maximally preserves the spinal integrity and stability, and reduces postoperative complications including cerebrospinal fluid leakage, pseudomeningocele, spinal deformity, and instability.