Replantation of lamina and spinous process using hollow screw in the surgery on thoracolumbar intraspinal tumors

English Keywords:Spinal cord neoplasms  Pinous process and vertebral plate complex  Cannulated screws  Laminoplasty

English Abstract:

  【Abstract】 Objectives: To explore the clinical effect of replantation of spinous process and vertebral plate complex by using cannulated screws for the primary intraspinal canal tumors． Methods: From February 2011 to October 2015, spinous process and vertebral plate complex replantation by using cannulated screws was performed in 31 patients after intraspinal tumor removal. 26 patients received follow-up(11 males and 15 females). Onset ages ranged from 29 to 76 years old(average, 46.5±8.4 years)． After surgery, CT and X-ray were used to assess the spinal stability and vertebral canal formation. MRl was adopted to evaluate the tumor recurrence. The Japanese Orthopaedic Association(JOA) was used to evaluate the curative effects. Results: During operation, all 64 cannulated screws were smoothly placed. The mean operation time was 75-148 min(96±21 min) and the mean bleeding volume was 170-305ml(225±32ml). Among these patients, 4 cases had a cerebrospinal fluid leakage, without spinal cord injury or infection. 26 patients were followed up for an average of 13.5±2.1 months(range, 6-28 months). X-ray showed no vertebral instability or spondylolisthesis. Although the facet joint was involved at two levels as shown by CT, no screw breakage or displacement was observed, and the fusion rate accounted for 76.9%. MRI showed no recurrence. The symptoms improved significantly after operation, the JOA score was 11.2±2.1 before surgery and 24.6±2.8 at final follow-up, significant difference existed between postoperation and preoperation(P＜0.05), with the excellent rate of 80.8%. Conclusions: The replantation of spinous process and vertebral plate complex by using cannulated screws after the resection of intraspinal canal tumors may reconstruct the vertebral canal and maintain the spinal stability, which is an effective procedure in avoiding iatrogenic spinal stenosis.