Efficacy of posterior laminectomy approach for treating intraspinal neurilemmoma

English Keywords:Neurilemmoma  Intraspinal  Posterior approach  Laminectomy  Efficacy

English Abstract:

  【Abstract】　Objectives:　To evaluate the efficacy of posterior laminectomy approach for treating intraspinal neurilemmoma． Methods：　A total of 71 cases(39 males, 32 females) with intraspinal neurilemmoma from January 2005 to January 2011 was reviewed retrospectively． The average age was 51.6 years(range, 25-99 years)． Of all cases, 22 cases had defect in cervical spine,　24 in thoracic,　25 in lumbar or sacral. 3 cases had defect in intramedullary,　66 in intradural extramedullary, and 2 cases in epidural. 57 patients underwent semi-laminectomy, 6 cases had laminectomy, 2 cases had multi-segmental semi-laminectomy, and 6 cases underwent semi-laminectomy combined with resection of ipsilateral facet joint process. Internal fixation and bone graft was performed in 14 cases． Involved nerve roots which can not be separated from the tumor were removed in 9 cases. Patients were followed up for 8-70 months, the clinical outcome, recurrence as well as spine stability were reviewed by MRl and X-ray． Results： The operative time was 2-6h, with an average of 3.5h, and blood loss was 300-800ml, with an average of 450ml. All tumors were totally resected and confirmed by pathological test. No spinal cord injury was noted during the operation. The CSF leakage was found in 12 patients, and spinal cord ischemia reperfusion injury was observed in 4 cases after surgery, which resolved after corresponsive treatment. All patients recovered during the follow-up period. No residual tumor or recurrence was noted. The bone graft had fusioned, and the location was very stable in all 14 paients who performed the spinal internal fixation and bone graft. No sponndylolisthesis and instability phenomena were observed in all 71 patients. Conclusions： The posterior laminectomy approach has the characteristics of the tumor exposed to the full, which will help to complete resection． The clinical outcomes in patients are satisfactory.