Application of the modified expanding suspended laminoplasty for spinal tumors

Objective To investigate the surgical application and indications of the modified expanding suspended laminoplasty for spinal tumors.Methods Clinical data of 38 cases of spinal tumors performed the modified laminoplasty were analyzed retrospectively.A modified surgical technique of lamina replantation and fixation were applied during the operation.The exposure and resection of tumors were analyzed.Clinical outcomes,spinal stability and complications were followed up and the indications of the surgical technique were discussed.Results According to the location of tumors,the segments of vertebral column involved in the operation varied from two to six(mean 3.5 segments).Six cases of dumbbell-shaped intra-and extra-spinal tumors,22 cases of spinal subdural tumors,and 10 cases of intramedullary tumors were included in the study.Total resection was achieved in 28 cases and subtotal resection in 10 cases.During 6 months~2 years' follow-up,JOA score was increased from 8.6±2.7 preoperation to 14.1±2.6 postoperation,with an improvement rate of 82.5%±9.4% and an excellent rate of 76.3%.The lamina replantation,fixation and bone-graft fusion were satisfactory in all the cases.The sagittal diameter of spinal canal was increased by 1~4 mm(mean 3.2 mm) postoperatively.There was no complications and spinal instability.Conclusion Modified expanding suspended laminoplasty is effective for tumor exposure and resection,with less influence on the spinal stability,less complications and better clinical outcomes.It is applicable to giant and multiple segment-involved spinal tumors,malignant tumors and those that can not be totally resected,with pediatric patients in particular.