Vertebral arch reconstruction based on 90 degree rotational laminoplasty after removal of spinal cord and cauda equina tumours.

BACKGROUND

A variety of procedures for reconstructing the spine following the removal of spinal cord and cauda equina tumours have been developed to prevent postoperative spinal deformities and nerve entrapment. The purpose of this paper is to introduce a new reconstructive procedure based on rotational laminoplasty and to report preliminary results in a small series.

METHOD: The trough is drilled at the border of the laminae and articular processes and the ligamentum flavum is resected on its cephalocaudal aspect, so the vertebral arch can be separated as a single mass. After tumour resection, the vertebral arch is removed en bloc with the laminae, and is rotated 90 degrees and placed on the articular facets and fixed using suture passing through holes drilled in the bone.

FINDINGS: One man and six women underwent rotational laminoplasty following resection of spinal or cauda equina tumours. Operative exposure was good and permitted complete resection. Patients did well postoperatively from both spine-surgical and neurosurgical points of view. Computed tomography documented a bony union with preservation of widely patent spinal canal.

INTERPRETATION: Rotational laminoplasty affords a satisfactory operative exposure for the resection of large, complex lesions. It creates a widely patent, stable spinal canal easily, without the need for special tools.