Thoracic laminectomy and anatomic implant in situ in the treatment of tumor in spinal canal

Objective To study the treatment of the tumor in spinal canal by thoracic laminectomy and anatomic implant in situ. Methods From August 1995 to December 2003, 56 patients had undergone thoracic laminectomy and anatomic im- plant in situ for the treatment of tumor in spinal canal, including 24 female and 32 male patients. The average age was 34.7 years old (ranging from 23 to 68 years old). 29 cases were located at T_1-T_6 and 37 cases at T_7-T_(12). The affected segment was 1 in 8 cases, 2 in 21 cases, 3 in 18 cases, 4 in 5 cases, 6 in 3 cases and 7 in 1 case. This group was epidural tumor in 43 cases, subdural tumor in 13 cases, schwannoma in 23 cases, meningioma in 18 cases, ependymoma in 7 cases,lipoma in 3 cases,cyst in 3 cases and teratoma in 2 cases including 9 cases recurrence operated. Results The surgical time ranged from 90 to 205 minutes (mean 137 minutes), and the blood loss ranged from 300 to 1400ml (mean 760 ml). We found that the lamina of vertebra needed 4. 5 to 6 months (mean 5 months) to heal according to postoperative X-rays, CT and MRI. The postoperative follow-up ranged from 3 to 38 months (mean 14 months). 15 cases had postoperative complications, including cerebrospinal fluid leakage in 4 cases, postoperative recurrence in 9 cases and intercostal neuralgia in 2 cases. Conclusion The treatment of the tumor in spinal canal by thoracic laminectomy and anatomic implant in situ is safer than for- mer procedure, which can avoid the further occupation in the spinal canal and the injury of spinal cord, and shorten the surgi- cal time. It also can recover the canal structure and diminish postoperative adhesion in the spinal canal, which is used for sec- ondary operation.