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Clinical and Biomechanical Study of Laminoplasty for Thoracic and Lumbar Intradural Tumors
(1) Background: Primary intraspinal tumors account for 2–15% of all central nervous system (CNS) tumors. Most intraspinal tumors are benign, and about 40% of them occur intradurally, for which early surgery is the preferred treatment. Laminectomy with pedicle screw fixation is the conventional surgi...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821651/ https://www.ncbi.nlm.nih.gov/pubmed/36615155 http://dx.doi.org/10.3390/jcm12010355 |
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author | Jiang, Lijun Luo, Jie Gong, Haiyi Zhang, Fei Zhang, Linxiang Cheng, Linfei Gao, Xin Zhang, Dan Liu, Tielong Xiao, Jianru |
author_facet | Jiang, Lijun Luo, Jie Gong, Haiyi Zhang, Fei Zhang, Linxiang Cheng, Linfei Gao, Xin Zhang, Dan Liu, Tielong Xiao, Jianru |
author_sort | Jiang, Lijun |
collection | PubMed |
description | (1) Background: Primary intraspinal tumors account for 2–15% of all central nervous system (CNS) tumors. Most intraspinal tumors are benign, and about 40% of them occur intradurally, for which early surgery is the preferred treatment. Laminectomy with pedicle screw fixation is the conventional surgical treatment. However, laminectomy with pedicle screw fixation is likely to reduce the spinal range of motion (ROM), with many other complications, although it can maintain the stability of the spine. The aim of this study is to determine whether laminoplasty as a new surgical approach for thoracic and lumbar intradural tumors is superior to laminectomy in preserving spinal ROM, maintaining spinal stability and reducing postoperative complications. (2) Methods: We retrospectively analyzed 50 patients who received intradural tumor resection, including 23 who received traditional laminectomy with pedicle screw fixation and 27 who received new laminoplasty. Spinal ROM was evaluated by lumbar flexion/extension radiograph and biomechanical evaluation. Spinal stability was evaluated by imaging observations of the spinal Cobb angle and laminar bone fusion. Postoperative complications were evaluated according to cerebrospinal fluid (CSF) leakage and the length of hospital stay. (3) Results: Compared with the laminectomy group, patients in the laminoplasty group exhibited a better spinal ROM (31.6 ± 12.0° vs. 21.7 ± 11.8°, p = 0.013), a smaller Cobb angle (9.6 ± 4.3 vs. 12.5 ± 5.3, p = 0.034), a lower incidence of CSF leakage (4/14.8% vs. 11/47.8%, p = 0.015), and a shorter length of hospital stay (13.1 ± 1.8 vs. 15.1 ± 2.3 days, p = 0.001). Most patients in the laminoplasty group had satisfactory bone fusion. The biomechanical experiment also demonstrated that spinal ROM in laminoplasty was larger than that in the laminectomy group. (4) Conclusions: Compared with the traditional surgery, the new laminoplasty surgery can better maintain the stability of the spine, preserve spinal ROM, and reduce postoperative complications. It is a surgical method that can be clinically popularized. |
format | Online Article Text |
id | pubmed-9821651 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98216512023-01-07 Clinical and Biomechanical Study of Laminoplasty for Thoracic and Lumbar Intradural Tumors Jiang, Lijun Luo, Jie Gong, Haiyi Zhang, Fei Zhang, Linxiang Cheng, Linfei Gao, Xin Zhang, Dan Liu, Tielong Xiao, Jianru J Clin Med Article (1) Background: Primary intraspinal tumors account for 2–15% of all central nervous system (CNS) tumors. Most intraspinal tumors are benign, and about 40% of them occur intradurally, for which early surgery is the preferred treatment. Laminectomy with pedicle screw fixation is the conventional surgical treatment. However, laminectomy with pedicle screw fixation is likely to reduce the spinal range of motion (ROM), with many other complications, although it can maintain the stability of the spine. The aim of this study is to determine whether laminoplasty as a new surgical approach for thoracic and lumbar intradural tumors is superior to laminectomy in preserving spinal ROM, maintaining spinal stability and reducing postoperative complications. (2) Methods: We retrospectively analyzed 50 patients who received intradural tumor resection, including 23 who received traditional laminectomy with pedicle screw fixation and 27 who received new laminoplasty. Spinal ROM was evaluated by lumbar flexion/extension radiograph and biomechanical evaluation. Spinal stability was evaluated by imaging observations of the spinal Cobb angle and laminar bone fusion. Postoperative complications were evaluated according to cerebrospinal fluid (CSF) leakage and the length of hospital stay. (3) Results: Compared with the laminectomy group, patients in the laminoplasty group exhibited a better spinal ROM (31.6 ± 12.0° vs. 21.7 ± 11.8°, p = 0.013), a smaller Cobb angle (9.6 ± 4.3 vs. 12.5 ± 5.3, p = 0.034), a lower incidence of CSF leakage (4/14.8% vs. 11/47.8%, p = 0.015), and a shorter length of hospital stay (13.1 ± 1.8 vs. 15.1 ± 2.3 days, p = 0.001). Most patients in the laminoplasty group had satisfactory bone fusion. The biomechanical experiment also demonstrated that spinal ROM in laminoplasty was larger than that in the laminectomy group. (4) Conclusions: Compared with the traditional surgery, the new laminoplasty surgery can better maintain the stability of the spine, preserve spinal ROM, and reduce postoperative complications. It is a surgical method that can be clinically popularized. MDPI 2023-01-02 /pmc/articles/PMC9821651/ /pubmed/36615155 http://dx.doi.org/10.3390/jcm12010355 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Jiang, Lijun Luo, Jie Gong, Haiyi Zhang, Fei Zhang, Linxiang Cheng, Linfei Gao, Xin Zhang, Dan Liu, Tielong Xiao, Jianru Clinical and Biomechanical Study of Laminoplasty for Thoracic and Lumbar Intradural Tumors |
title | Clinical and Biomechanical Study of Laminoplasty for Thoracic and Lumbar Intradural Tumors |
title_full | Clinical and Biomechanical Study of Laminoplasty for Thoracic and Lumbar Intradural Tumors |
title_fullStr | Clinical and Biomechanical Study of Laminoplasty for Thoracic and Lumbar Intradural Tumors |
title_full_unstemmed | Clinical and Biomechanical Study of Laminoplasty for Thoracic and Lumbar Intradural Tumors |
title_short | Clinical and Biomechanical Study of Laminoplasty for Thoracic and Lumbar Intradural Tumors |
title_sort | clinical and biomechanical study of laminoplasty for thoracic and lumbar intradural tumors |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821651/ https://www.ncbi.nlm.nih.gov/pubmed/36615155 http://dx.doi.org/10.3390/jcm12010355 |
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