Treatment of benign tumors in the lumbar spinal canal by recapping laminoplasty preserving the continuity of superior spinous ligament
10.3760/cma.j.cn115354-20220323-00157
- VernacularTitle:保留棘上韧带连续性的椎板回植术在治疗腰椎管内良性肿瘤中的应用
- Author:
Yuwei LI
1
;
Haijiao WANG
;
Wei CUI
;
Peng ZHOU
;
Fan LI
;
Yuanhao LIU
;
Jingyi XU
;
Tiantian TANG
Author Information
1. 漯河市中心医院脊柱骨科，漯河 462000
- Keywords:
Lumbar spine;
Intraspinal tumor;
Supraspinous ligament;
Spinous process lamina complex;
Lumbar lordosis angle
- From:
Chinese Journal of Neuromedicine
2022;21(5):469-473
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of recapping laminoplasty preserving the continuity of superior spinous ligament in the treatment of benign tumors in the lumbar spinal canal.Methods:A retrospective analysis was performed. The clinical data of 23 patients with benign tumors in lumbar spinal canal, admitted to our hospital from March 2018 to March 2020, were collected. Follow up was performed for 12-23 months; Japanese Orthopaedic Association (JOA) scores were used for efficacy evaluation. X-ray, CT and MRI were used for imaging evaluation.Results:The number of replanted lamina was 1-4, with an average of 2.2. The surgical duration was (77.2±22.7) min, ranged from 67 min to 146 min; and the amount of intraoperative bleeding was (127±32.6) mL, ranged from 90-290 mL. The tumors were completely removed in all patients, and there were 2 patients complicated with cerebrospinal fluid leakage, and the wound healed after electrolyte supplement and local pressure treatment. No spinal cord injury, epidural hematoma, infection or other related complications were noted. The JOA scores increased from 11.85±1.38 before surgery to 23.22±2.47 at the last follow-up, with significant difference ( t=18.505, P<0.001). Of them, 10 had excellent efficacy, 9 had good efficacy, and 4 had medium efficacy, enjoying an excellent and good rate of 82.6%. Lumbar lordosis angle (LLA) was (51.58±2.39)°at the last follow-up, which showed no significant difference as compared with the preoperative LLA ([52.24±3.17]°, t=0.672, P=0.505). Imaging results showed that there was no spondylolisthesis or instability of lumbar spine, no recurrence of tumors was noted, and no displacement of lamina or secondary reduction of spinal canal volume were noted. Conclusion:The treatment of benign tumors in lumbar spinal canal by modified recapping laminoplasty preserving the continuity of superior spinous ligament can restore the normal anatomical structure of lumbar spinal canal, achieve no bone loss and maintain lumbar curvature well.
