Efficacy analysis of two surgical treatments for thoracic and lumbar intraspinal tumours

摘要

Surgery remains the main curative option for the treatment of intraspinal tumour. The purpose of the present study was to analyze the clinical outcomes of laminoplasty with process-lamina complex replantation compared with laminectomy with pedicle screw fixation for intraspinal tumours. In our retrospective analysis, 27 patients received tumour resection surgery by laminoplasty with reconstruction plate fixation and 32 patients received laminectomy with pedicle screw fixation. All patients were followed up for at least 1?year. Data, including surgical time, blood loss, volume of drainage, drainage time, hospital stay, complications, and neurological status were compared. In addition, imaging evaluation was also included. Patients in the laminoplasty group had lower blood loss (laminoplasty group: 281.5?±?130.2?mL; laminectomy group: 450.0?±?224.3?mL; p?=?0.001), shorter surgical time (laminoplasty group: 141.7?±?26.2?min, laminectomy group: 175.3?±?50.4?min; p?=?0.003), lower volume of drainage (laminoplasty group: 1578.9?±?821.7?mL, laminectomy group: 2621.2?±?1351.0?mL; p?=?0.001), shorter drainage time (laminoplasty group: 6.6?±?2.5?days, laminectomy group: 9.7?±?1.8?days; p?=?0.000), and a shorter hospital stay (laminoplasty group: 16.9?±?4.9?days, laminectomy group: 21.0?±?4.4?days; p?=?0.002) compared with patients in the laminectomy group. There were significant differences of oswestry dysfunction index (ODI) between the two groups at 12?months postoperatively (p?=?0.034). The incidence of secondary spinal stenosis in the laminoplasty group was significantly reduced (p?=?0.029). Laminoplasty in intraspinal tumour resection has a lower blood loss and volume of drainage, shorter surgical time and hospital stay as advantages over the standard laminectomy technique. Moreover, laminoplasty can effectively avoid iatrogenic spinal canal stenosis and thus enhancing functional recovery of spinal cord.