Abstract:
INTRODUCTION:Intraspinal tumours are rare and principally managed surgically. Laminectomy, employed for access to the spinal canal, destroys the posterior tension band leading to a risk of kyphosis. Hemilaminectomy as an alternative may be less destructive, potentially reducing the risk of deformity and causing less post-operative pain. METHOD:We investigated this hypothesis by retrospectively reviewing a case series of 56 surgeries for a disparate and unselected group of intraspinal tumours utilizing a laminectomy or hemilaminectomy approach. RESULTS:No difference was found in length of operation, completeness of resection, complication rate and Frankel-score improvements. Hemilaminectomy (n = 22) is associated with reduced hospital stay (post-op days) 4.5 (2-6) versus 6 (3-8), (p = 0.026, Mann-Whitney), and a reduction in post-operative morphine use (mg) 10 (3.5-28) versus 30 (10-90), (p = 0.005, Mann-Whitney). Post-operative kyphosis was measured with the Harrison posterior tangent method on T2-weighted sagittal MR images. The average change in kyphosis angle was greater in the laminectomy group compared with the hemilaminectomy group, 3.6 (0.8-6.2) versus 0.4 (-0.2-1.2), statistically significant (p = 0.004, Mann-Whitney). CONCLUSION:Hemilaminectomy is as effective an access procedure for the resection of unselected intraspinal tumours as laminectomy, but is associated with shorter post-operative stays, lower analgesic requirements and less post-operative kyphosis.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Millward CP,Bhagawati D,Chan HW,Bestwick J,Brecknell JEdoi
10.3109/02688697.2014.1003026subject
Has Abstractpub_date
2015-06-01 00:00:00pages
390-5issue
3eissn
0268-8697issn
1360-046Xjournal_volume
29pub_type
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journal_title:British journal of neurosurgery
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doi:10.1080/02688690050175283
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journal_title:British journal of neurosurgery
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journal_title:British journal of neurosurgery
pub_type: 杂志文章,随机对照试验
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